Senate Bill S3883B

                                 
BILL NUMBER: S3883

SPONSOR: HINCHEY
 
TITLE OF BILL:

An act to amend the public health law, in relation to dispensing certain
controlled substances for use by a person with a substance use disorder

 
PURPOSE:

Allows paramedics to administer controlled substances when responding to
a person who has acute withdrawal symptoms.

 
SUMMARY OF PROVISIONS:

Section one:

* Amends subdivision 1 of section 3351 of the public health law to
update terminology of "addict" to "person with a substance use disor-
der."

* Adds a new subdivision 1-a to section 3351 of the public health law to
              

authorize a practitioner to prescribe, administer, or dispense schedule
III, IV, or V narcotics specifically for use in maintenance or detoxifi-
cation treatment to a person with a substance use disorder or habitual
user.

* Amends subdivision 2 of section 3351 of the public health law to allow
advanced emergency medical technician-paramedics, acting within their
scope of practice, to administer controlled substances to relieve acute
withdrawal symptoms in those who are dealing with a substance use disor-
der.

Section two establishes the effective date.

 
JUSTIFICATION:

Patients with opioid use disorder who have overdosed and require nalox-
one reversal are at increased risk for recurrent overdose and death and
also present an opportunity for intervention. Buprenorphine, a partial
opioid antagonist, provides some relief from opioid withdrawal symptoms.

It is safe and effective for paramedic administration. A pilot project
in California came to the conclusion that EMS administered buprenorphine
is possible, safe, and results in significant retention in care at 30
days. Prehospital initiation of buprenorphine treatment for opioid use
disorder (OUD) by paramedics is an emerging potential intervention to
reach the patients at greatest risk for opioid-related deaths.

Emergency medical services (EMS) patients who are at high risk for over-
dose deaths may never engage In treatment as they frequently decline
transport to the hospital after naloxone reversal Not only is there a
high level of stigma in treating these patients, but also there is a
lack of training and education among EMS personnel about the acute
treatments for OUD in the emergency department.

Strong evidence suggests that the initiation of medication for opioid
use disorder (MOUD) is the single most effective intervention to prevent
overdose deaths in patients with OUD and that increasing access to medi-
cation should be a national public health priority.  (from H. Gene Hem,
Vanessa Lara, David Goldstein, M. Kalmin, S. Kidane, S. Shoptaw, Ori
Tzvieli & Andrew A. Herring (2023) Prehospital Buprenorphine Treatment
for Opioid Use Disorder by Paramedics: First Year Results of the EMS
Buprenorphine Use Pilot, Prehospital Emergency Care, 27:3, 334-342, D
01:10.1080/10903127.2022,2061661)

 
LEGISLATIVE HISTORY:

Minor changes but substantively similar to S.9926/A.9882 of 2024
(referred to Senate Rules / Assembly Health.)

 
FISCAL IMPLICATIONS:

None to the State

 
EFFECTIVE DATE:
This act shall take effect immediately.

                                 
BILL NUMBER: S3883A

SPONSOR: HINCHEY
 
TITLE OF BILL:

An act to amend the public health law, in relation to dispensing certain
controlled substances for use by a person with a substance use disorder

 
PURPOSE:

Allows EMT-Paramedics to administer controlled substances when respond-
ing to a person who has acute withdrawal symptoms.

 
SUMMARY OF PROVISIONS:

Section one:

* Amends subdivision 1 of section 3351 of the public health law to
update terminology of "abuse" of controlled substances to "substance us
disorder or habitual substance use."

* Amends subdivision 2 of section 3351 of the public health law to allow
              

advanced emergency medical technician-paramedics, acting within their
scope of practice, to administer controlled substances to relieve acute
withdrawal symptoms in those who are dealing with a substance use disor-
der.

Section two establishes the effective date.

 
JUSTIFICATION:

Patients with opioid use disorder who have overdosed and require nalox-
one reversal are at increased risk for recurrent overdose and death and
also present an opportunity for intervention.  Buprenorphine, a partial
opioid antagonist, provides some relief from opioid withdrawal symptoms.

It is safe and effective for paramedic administration. A pilot project
in California came to the conclusion that EMS administered buprenorphine
is possible, safe, and results in significant retention in care at 30
days. Prehospital initiation of buprenorphine treatment for opioid use
disorder (OUD) by paramedics is an emerging potential intervention to
reach the patients at greatest risk for opioid-related deaths.

Emergency medical services (EMS) patients who are at high risk for over-
dose deaths may never engage In treatment as they frequently decline
transport to the hospital after naloxone reversal Not only is there a
high level of stigma in treating these patients, but also there is a
tack of training and education among EMS personnel about the acute
treatments for OUD in the emergency department.

Strong evidence suggests that the initiation of medication for opioid
use disorder (MOUD) is the single most effective intervention to prevent
overdose deaths in patients with OUD and that increasing access to medi-
cation should be a national public health priority.  (from H. Gene Hem,
Vanessa Lara, David Goldstein, M. Kalmin, S.  Kidane, S. Shoptaw, Ori
Tzvieli & Andrew A. Herring (2023) Prehospital Buprenorphine Treatment
for Opioid Use Disorder by Paramedics: First Year Results of the EMS
Buprenorphine Use Pilot, Prehospital Emergency Care, 27:3, 334-342, D
01:10.1080/10903127.2022,2061661)
 
LEGISLATIVE HISTORY:

Minor changes but substantively similar to S.9926/A.9882 of 2024
(referred to Senate Rules / Assembly Health.)

 
FISCAL IMPLICATIONS:

None to the State

 
EFFECTIVE DATE:
This act shall take effect immediately.