Medication Assisted Treatment Bills Considered by Legislature in Lame Duck

On Wednesday, November 28, the House Health Committee heard testimony on two separate bills that each aim to expand access to Medication Assisted Treatment (MAT) for opioid use disorders by loosening restrictions on pharmacists who dispense or administer MAT drugs. Proponents of Senate Bill 119 and House Bill 601 each testified to the importance of improving the accessibility of MAT as a means of continuing to combat the state’s opioid crisis.

Senate Bill 119 (Hackett, Hottinger) authorizes pharmacists to dispense or administer the MAT drug naltrexone (brand name “Vivitrol”) under certain conditions. Senators Bob Hackett and Jay Hottinger, the bill’s lead sponsors, told the House Health Committee that the bill would ensure patients who have already been prescribed naltrexone can continue their treatment in the event that they experience a gap in insurance coverage, their doctor quits practicing, they are traveling, or they are unable to make their next scheduled doctor’s visit. Under such circumstances, the bill would permit pharmacists to dispense an emergency five-day oral supply of naltrexone, provided they are able to verify that the patient is already on naltrexone therapy. Pharmacists would also be able to administer a naltrexone injection, provided they follow existing protocols established in Ohio law.

As of January 2018, Ohio had only 32 certified dispensers of methadone and 77 licensed dispensers of buprenorphine

House Bill 601 (Ginter) goes a step further by authorizing pharmacists to administer by injection all FDA-approved MAT drugs prescribed by a physician. Current law only allows pharmacists to administer “opioid antagonists,” such as naltrexone by injection. Opioid antagonists work by blocking the effects of opioids on the brain. Under House Bill 601, pharmacists would be permitted to administer “agonist” MAT drugs as well. Opioid agonists, such as methadone and buprenorphine, are slow-acting opioids that work to reduce cravings without causing the powerful high experienced with regular opioids. While there have been concerns in the past about the potential for abuse of drugs like methadone when taken in large doses, House Bill 601 deals only with administration of these drugs by injection by a pharmacist or health care professional. In other words, it seeks to expand access to all forms of MAT, without increasing the risk of diversion or misuse by dispensing more drugs to patients for use at home. The bill also loosens licensure requirements on healthcare providers that administer any MAT drugs by injection only.

As of January 2018, Ohio had only 32 certified dispensers of methadone and 77 licensed dispensers of buprenorphine. Naltrexone can be prescribed in any healthcare setting by any licensed prescriber, making it more accessible than the others. Proponents of House Bill 601 say it will help to level the playing field between all MAT drugs by making them equally accessible by injection.

Two bills aim to expand access to Medication Assisted Treatment for opioid use disorders. Ohio House Health Committee heard testimony on both - read more here Click To Tweet

Senate Bill 119 has been passed by the Senate and is virtually identical to House Bill 167 (Edwards), which was passed unanimously by the House earlier this year. Though Wednesday was technically the Senate Bill’s first hearing in the House Health Committee, it is expected to move through the House fairly easily during the lame duck session given that the chamber has already passed its own version of the bill with no controversy. House Bill 601 received its second hearing in front of House Health on Wednesday, and would still need to be reported favorably out of committee and be passed by the House before being considered by the Senate. Members of the House Health Committee heard only sponsor and proponent testimony for the two bills, and raised no questions for those testifying on either bill. The bills have until December 19, the last day of scheduled session for the 132nd General Assembly, to be passed by the legislature and sent to the governor’s desk.