BILL ANALYSIS Ó SB 1438 Page 1 SENATE THIRD READING SB 1438 (Pavley) As Amended August 22, 2014 Majority vote SENATE VOTE : 31-0 HEALTH 17-0 JUDICIARY 9-0 ----------------------------------------------------------------- |Ayes:|Pan, Maienschein, |Ayes:|Wieckowski, Wagner, | | |Ammiano, Bonilla, Bonta, | |Alejo, Chau, Dickinson, | | |Chesbro, Gomez, Gonzalez, | |Garcia, Maienschein, | | |Roger Hernández, | |Muratsuchi, Stone | | |Lowenthal, Mansoor, | | | | |Nazarian, Nestande, | | | | |Patterson, Ridley-Thomas, | | | | |Rodriguez, Wieckowski | | | | | | | | ----------------------------------------------------------------- APPROPRIATIONS 17-0 -------------------------------------- |Ayes:|Gatto, Bigelow, | | | |Bocanegra, Bradford, Ian | | | |Calderon, Campos, | | | |Donnelly, Eggman, Gomez, | | | |Holden, Jones, Linder, | | | |Pan, Quirk, | | | |Ridley-Thomas, Wagner, | | | |Weber | | | | | | -------------------------------------- SUMMARY : Adds peace officers to those allowed to administer an opioid antagonist to a person at risk of an opioid-related overdose. Requires the Emergency Medical Services Authority (EMSA) to develop and adopt training and standards for all prehospital emergency care personnel regarding the use and administration of naloxone hydrochloride (naloxone) and other opioid antagonists and to include the administration of naloxone in the training and scope of practice, consistent with current law, for emergency medical technician I (EMT-I) certification. Requires the Attorney General to authorize hospitals and trauma centers to share data on controlled substance overdose trends with local law enforcement agencies and local emergency medical SB 1438 Page 2 services agencies, as specified. FISCAL EFFECT : According to the Assembly Appropriations Committee: 1)One-time staff costs, not likely to exceed $100,000 for EMSA to issue regulations. 2)Local and private costs will be incurred as well. Local and private EMS [Emergency Medical Services] agencies who have not adopted naloxone administration on a voluntary basis will incur costs for policy development and revising training curriculum. EMT-Is will incur a cost of $50-80 each for the additional training. These costs are not state-reimbursable. COMMENTS : According to the author, California and the nation are in the midst of a drug abuse crisis. Drug overdoses are the leading cause of accidental death in the United States (U.S.), killing about 38,000 people each year. Prescription opioid and heroin abuse have precipitated a public health epidemic marked by a spike in fatal overdoses. While naloxone, an opiate antidote that reverses opiate overdoses, has been used by paramedics and advanced emergency medical technicians (EMTs) to save lives for the last few decades, current law is unclear about the ability of other first emergency responders, such as law enforcement, to use this medication. According to the sponsor, the California Professional Firefighters (CPF), under current law, a doctor can prescribe naloxone to a patient, their family member, or a friend to assist a person who is at risk of an opioid overdose and those individuals may also take part in a training program for the administration of opioid antagonists. CPF states that this bill would add prehospital care personnel to the list of people who can receive a prescription and training for an opioid antagonist for the purposes of assisting a person at risk of an overdose. While paramedics and EMTs are often the first to respond to a medical emergency, some localities report that peace officers are increasingly the first to encounter an overdose victim. A recent internal survey within the San Diego Sheriff's Department found that sheriff's deputies responded to over 200 overdose-related emergency calls in the first nine months of 2013. In over 50% of those cases, the sheriff's deputy was the first emergency responder on the scene. Last month, in recognition of the nationwide surge in opiate overdoses, U.S. SB 1438 Page 3 Attorney General Eric Holder echoed the plea made by the director of the White House Office of National Drug Control Policy to train and equip law enforcement officers with naloxone. According to the U.S. Food and Drug Administration, naloxone, which is not a controlled substance, rapidly reverses the effects of opioid overdose and is the standard treatment for overdose, which is characterized by decreased breathing or heart rate or loss of consciousness. When administered quickly and effectively, naloxone immediately restores breathing to a victim in the throes of an opioid overdose. According to the Drug Policy Alliance's (DPA) Internet Web site, naloxone has been safely and effectively used for more than 40 years in ambulances and emergency rooms across the country. Naloxone has no potential for abuse and side effects are rare. The Drug Policy Alliance also cites ongoing research showing that expanding access to naloxone does not promote increased drug use or risk-taking behavior that results in unintended overdoses. Law enforcement agencies in other states have been successfully carrying and administering naloxone. The police officers in Quincy, a suburb of Boston, Massachusetts, have been carrying a nasal form of naloxone since October 2010. Quincy officers have administered the drug 221 times and reversed 211 overdoses. In New York, Staten Island police officers have been trained to administer the spray as part of a pilot program to fight the high rate of painkiller abuse. DPA writes that this bill is an urgently needed measure to allow first responders to administer opiate overdose reversal medication to a person at risk of a fatal overdose. The San Diego Sheriff's Department writes in support of providing naloxone to and the training of deputies and officers in the administration of the opioid antagonist in order to help efforts in San Diego County to stem the tide of overdose-related deaths in their community. The San Diego Sheriff's Department recently conducted an internal survey and found that their deputies responded to over 200 overdose-related emergency calls in the first nine months of 2013, and in over half of those cases the deputy was the first emergency responder on the scene. This bill has no known opposition. SB 1438 Page 4 Analysis Prepared by : Patty Rodgers / HEALTH / (916) 319-2097 FN: 0005330