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 ****