Texas Gov. Greg Abbott recently listed the fentanyl crisis as one of seven “emergency” items this session, clearing a path toward passage of Texas Medical Association-backed legislation that aims to curb opioid-related deaths.
TMA already is tracking several measures that could help improve the state’s crisis response by legalizing fentanyl test strips, increasing the state’s supply of the opioid antidote naloxone, and easing physician use of Texas’ prescription monitoring program (PMP).
- House Bill 362 by Rep. Tom Oliverson, MD (R-Cypress), which, along with several similar bills, would legalize the use, possession, delivery, and manufacturing of fentanyl testing equipment.
- HB 1543 by Representative Oliverson, which, along with two similar bills, would direct the Texas Department of State Health Services to issue a statewide standing order prescribing an opioid antidote to a person at risk of an overdose or a person in a position to help in such a scenario.
Governor Abbott signaled his support for the latter set of bills during his Feb. 16 State of the State address, saying Texas must “increase the supply of lifesaving Narcan” – a brand name for naloxone – “so we can save more Texans who are ambushed by fentanyl.”
These bills could be fast-tracked given Governor Abbott’s declaration of the fentanyl crisis as an emergency item this session. State lawmakers are prohibited from voting on bills, except those related to emergency items, before the March 10 bill-filing deadline.
Meanwhile, at the federal level, an advisory panel to the Food and Drug Administration (FDA) recently recommended Narcan be made available over the counter, increasing the likelihood FDA approves such a drug. Also, Congress eliminated a major restriction on prescribing buprenorphine, one of the most effective medications for treating opioid use disorder.
In addition, Texas’ preliminary budget bills from both the House and the Senate include funding for licensing fees related to the PMP, which physicians are required by state law to consult when prescribing certain opioids and other controlled substances.
Physicians don’t have to pay to access the PMP, but they do have to pay fees to keep their electronic health record integrated with the program. Michelle Romero, TMA associate vice president of public affairs, says the $7 million budget item could help remove what has amounted to an “unfunded mandate” for physicians over the past few years.
Testifying on TMA’s behalf, Mesquite pain management specialist C.M. Schade, MD, endorsed these interventions, along with other TMA recommendations, during a Sept. 13 interim meeting of the House Committee on Public Health.
“The ‘opioid crisis’ is no longer just about prescription opioids,” he testified, emphasizing that the main driver is illegally manufactured fentanyl. “It is time for us to reexamine our processes and change course.”
TMA’s other recommendations include:
- Investing in effective data mining software to compare pharmacy purchases with pharmacy PMP sales to spot illegal prescribing and dispensing;
- Improving education and prevention programs about opioids;
- Expanding mental health and substance use disorder services;
- Improving data collection to identify at-risk populations; and
- Creating community-based syringe service programs, which can connect people with addiction to the largest health care system for treatment and other services.