BILL ANALYSIS Ó AB 679 Page 1 (Without Reference to File) CONCURRENCE IN SENATE AMENDMENTS AB 679 (Travis Allen) As Amended September 10, 2015 2/3 vote. Urgency -------------------------------------------------------------------- |ASSEMBLY: | |(June 1, 2015) |SENATE: | |(September 11, | | |52-14 | | | |2015) | | | | | | | | | | | | | | | -------------------------------------------------------------------- (vote not available) Original Committee Reference: L. GOV SUMMARY: Extends the date by which specified health care practitioners and pharmacists must register with the Controlled Substance Utilization Review and Evaluation System (CURES) Prescription Drug Monitoring Program (PDMP) by six months, from January 1, 2016 to July 1, 2016. The Senate amendments: AB 679 Page 2 1) Requires that a healthcare practitioner authorized to prescribe, order, administer, furnish, or dispense Schedule II, Schedule III, or Schedule IV controlled substances submit an application to the Department of Justice (DOJ) to obtain approval to access CURES before July 1, 2016 or upon receipt of a federal Drug Enforcement Agency registration, whichever occurs later. 2) Requires a pharmacist to submit an application to the DOJ to obtain approval to access to CURES before July 1, 2016 or upon licensure, whichever occurs later. 3) Contains an urgency clause, stating that its immediate effect is necessary to ensure that health care practitioners and pharmacists are not out of compliance with the requirement to apply to access data contained in the CURES PDMP on January 1, 2016. FISCAL EFFECT: Unknown. This bill is keyed fiscal by Legislative Counsel. COMMENTS: Purpose. This bill is author sponsored. According to the author, "This bill is necessary because the updated version of CURES is not fully operational at this time and licensees need an additional six months in order to comply with statutory registration mandates." Controlled Substances. Through the Controlled Substances Act of 1970, the federal government regulates the manufacture, distribution and dispensing of controlled substances. The act ranks into five schedules those drugs known to have potential for physical or psychological harm, based on three considerations: 1) their potential for abuse; 2) their accepted AB 679 Page 3 medical use; and, 3) their accepted safety under medical supervision. The schedules are as follows: 1)Schedule I controlled substances have a high potential for abuse and no generally accepted medical use such as heroin, ecstasy, and LSD. 2)Schedule II controlled substances have a currently accepted medical use in treatment, or a currently accepted medical use with severe restrictions, and have a high potential for abuse and psychological or physical dependence. Schedule II drugs can be narcotics or non-narcotic. Examples of Schedule II controlled substances include morphine, methadone, Ritalin, Demerol, Dilaudid, Percocet, Percodan, and Oxycontin. 3)Schedule III and IV controlled substances have a currently accepted medical use in treatment, less potential for abuse but are known to be mixed in specific ways to achieve a narcotic-like end product. Examples include drugs include Vicodin, Zanex, Ambien and other anti-anxiety drugs. 4)Schedule V drugs have a low potential for abuse relative to substances listed in Schedule IV and consist primarily of preparations containing limited quantities of certain narcotics. The three classes of prescription drugs that are most commonly abused are: 1) opioids, which are most often prescribed to treat pain; 2) central nervous system depressants, which are used to treat disorders such as anxiety and sleep disorders; and 3) stimulants, which are prescribed to treat disorders such as narcolepsy and attention deficit hyperactivity disorder. Each class can induce euphoria, and when administered by routes other than recommended, such as snorting or dissolving into liquid to drink or inject, can intensify that sensation. Opioids, in particular, act on the same receptors as heroin and can be highly addictive. Common opioids include: hydrocodone AB 679 Page 4 (Vicodin), oxycodone (OxyContin), propoxyphene (Darvon), hydromorphone (Dilaudid), meperidine (Demerol), and diphenoxylate (Lomotil). Controlled Substance Utilization Review and Evaluation System (CURES). In California, the CURES is an electronic tracking program that reports all pharmacy (and specified types of prescriber) dispensing of controlled drugs by drug name, quantity, prescriber, patient, and pharmacy. Data from the CURES is managed by the DOJ to assist state law enforcement and regulatory agencies in their efforts to reduce prescription drug diversion. The CURES provides information that offers the ability to identify if a person is "doctor shopping" (when a prescription drug addict visits multiple doctors to obtain multiple prescriptions for drugs, or uses multiple pharmacies to obtain prescription drugs). Information tracked in the system contains the patient name, prescriber name, pharmacy name, drug name, amount and dosage, and is available to law enforcement agencies, regulatory bodies and qualified researchers. The system can also report on the top drugs prescribed for a specific time period, drugs prescribed in a particular county, doctor prescribing data, pharmacy dispensing data, and assists in assessing whether multiple prescriptions for the same patient may exist. CURES data can be obtained by the Medical Board, the Dental Board, the Board of Registered Nursing, the Osteopathic Medical Board and the Veterinary Medical Board. Senate Bill 809. In 2013, SB 809 (DeSaulnier, Chapter 400, Statutes of 2013) established the requirement and increased licensing fees to help fund the CURES database. However, a component of SB 809 related to the application process has not yet been implemented. In addition to the requirement for covered healthcare practitioners to apply for CURES, SB 809 required the DOJ, in conjunction with the DCA and the relevant licensing and regulatory entities, to establish a streamlined application to help facilitate the applications of the thousands of licensees. The application process was originally estimated to be available to licensees in the summer of 2015, which would have allowed six months for licensees to utilize the new process for their application; however, the streamlined registration AB 679 Page 5 process is now expected to be ready by July 1, 2016. This bill delays the implementation date by six months to ensure a more streamlined process for provider enrollment. Analysis Prepared by: Le Ondra Clark Harvey, Ph.D. / B. & P. / (916) 319-3301 FN: 0002444