BILL ANALYSIS ------------------------------------------------------------ |SENATE RULES COMMITTEE | AB 2268| |Office of Senate Floor Analyses | | |1020 N Street, Suite 524 | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ------------------------------------------------------------ THIRD READING Bill No: AB 2268 Author: Chesbro (D) Amended: 4/20/10 in Assembly Vote: 21 SENATE HEALTH COMMITTEE : 5-0, 6/9/10 AYES: Alquist, Cedillo, Leno, Negrete McLeod, Pavley NO VOTE RECORDED: Strickland, Aanestad, Cox, Romero ASSEMBLY FLOOR : 71-0, 4/26/10 - See last page for vote SUBJECT : Alcohol and drug abuse SOURCE : Department of Alcohol and Drug Programs DIGEST : This bill authorizes physicians and surgeons in California who are registered with the U.S. Attorney General, pursuant to specified federal law, to provide addiction treatments that are allowed under federal law. ANALYSIS : Existing law: 1.Establishes the Department of Alcohol and Drug Program (DADP) to license treatment facilities that provide a broad range of services in a supportive environment to adults who are addicted to alcohol or drugs. 2.Requires DADP to license and inspect narcotic treatment programs (NTPs), which use replacement narcotic therapy (RNT) in the treatment of addicted persons whose CONTINUED AB 2268 Page 2 addiction was acquired or supported by the use of a narcotic drug or drugs, not in compliance with a physician and surgeon's legal prescription. 3.Authorizes the following controlled substances for use in RNT by licensed NTPs: methadone, Levo-alphacetylmethadol (LAAM), buprenorphine products or combination products approved by the federal Food and Drug Administration (FDA) for maintenance or detoxification of opioid dependence, and any other federally approved controlled substances used for the purpose of RNT. 4.Requires DADP to establish a program for the operation and regulation of office-based opiate treatment (OBOT) programs that are required to hold a primary NTP license or be affiliated and associated with a primary licensed NTP. 5.Defines an OBOT program as a program in which interested and knowledgeable physicians provide addiction treatment services, and in which community pharmacies supply necessary medication both to these physicians for distribution to patients and through direct administration and dispensing services. 6.Requires physicians in OBOT programs to dispense or administer pharmacologic treatment for opiate addiction that has been approved by the FDA. This bill authorizes physicians and surgeons in California who are registered with the U.S. Attorney General, pursuant to specified federal law, to provide addiction treatments that are allowed under federal law. Background Buprenorphine is used to treat addiction to opioids by preventing withdrawal symptoms so that a person can stop taking the opioid drug to which he or she is addicted. In October 2002, the FDA approved two buprenorphine products, Subutex and Suboxone, for use in opioid addiction treatment. Subutex and Suboxone were the first narcotic drugs available for the treatment of opiate dependence that can be prescribed in an office setting under the federal AB 2268 Page 3 Data Addiction Treatment Act (DATA) of 2000. Prior to DATA, opiate dependence treatments like methadone could be dispensed in a limited number of clinics that specialize in addiction treatment. Under DATA, medications for the treatment of opiate dependence are subject to less restrictive controls. Buprenorphine can be prescribed in an office-based setting by specially qualified physicians, and patients can obtain a 30-day supply from a pharmacy. FISCAL EFFECT : Appropriation: No Fiscal Com.: No Local: No SUPPORT : (Verified 6/10/10) Department of Alcohol and Drug Programs (source) California Association of Alcoholism and Drug Abuse Counselors California Medical Association City and County of San Francisco Drug Policy Alliance ARGUMENTS IN SUPPORT : DADP writes that this bill will eliminate the legal risk to over 1,200 qualified physicians in California who are already prescribing buprenorphine in their offices, not knowing that state law does not conform to DATA. DADP states that this bill will clarify that qualified physicians in California are authorized to treat opioid dependence in their private practices as they would any other illness, subject to the requirements of DATA, and would substantially increase access to treatment for underserved populations in rural areas that do not have NTPs or clients who use public transit and must travel hours to the nearest NTP. Supporters, including the California Medical Association, Drug Policy Alliance and the California Association of Alcoholism and Drug Counselors, add that this bill will increase access for patients in need of detoxification and maintenance treatments and enable physicians to treat their patients with the full complement of services at their disposal. ASSEMBLY FLOOR : AYES: Adams, Ammiano, Anderson, Beall, Tom Berryhill, Blakeslee, Block, Blumenfield, Bradford, Brownley, AB 2268 Page 4 Buchanan, Caballero, Charles Calderon, Carter, Chesbro, Conway, Cook, Coto, Davis, De La Torre, De Leon, DeVore, Emmerson, Eng, Evans, Feuer, Fletcher, Fong, Fuentes, Fuller, Gaines, Galgiani, Garrick, Gilmore, Hagman, Harkey, Hayashi, Hernandez, Hill, Huber, Huffman, Jeffries, Jones, Knight, Lieu, Logue, Bonnie Lowenthal, Ma, Mendoza, Miller, Monning, Nava, Nestande, Niello, Nielsen, Norby, Portantino, Ruskin, Saldana, Silva, Skinner, Smyth, Solorio, Audra Strickland, Swanson, Torlakson, Torres, Torrico, Tran, Villines, Yamada NO VOTE RECORDED: Arambula, Bass, Bill Berryhill, Furutani, Hall, V. Manuel Perez, Salas, John A. Perez CTW:nl 6/10/10 Senate Floor Analyses SUPPORT/OPPOSITION: SEE ABOVE **** END ****