Every week, an average of five Oregonians die from opioid overdose, according to the Oregon Health Authority, and it’s not all because of fentanyl sold on the street. The state has one of the highest rates of prescription opioid “misuse,” according to OHA.
Given that, you’d think that Oregon legislators would have more interest in a bill requiring pharmacists to offer naloxone (better known by its brand name Narcan) or another overdose-reversal medication when they fill prescriptions for higher doses of opioid-based painkillers.
But House Bill 4081 likely will go nowhere in the short legislative session that ends March 7, because it hasn’t cleared hurdles that take more time than is left.
Rep. Rachel Prusak (D-West Linn) has been pressing for naloxone requirements since the long legislative session last year, when a similar bill she sponsored also failed to advance.
“It’s a tragedy that this won’t pass this session,” Prusak said in an interview. She has personal experience with naloxone. It has saved her brother’s life more than once, she said.
This was probably Prusak’s last chance at passing the bill. She was one of three House Democrats who said today that they would not seek reelection this year in the light of the apparent failure of a bill that would have doubled lawmakers’ pay and provided extra compensation for child care. Reps. Karin Power (D-Milwaukie) and Anna Williams (D-Hood River) also said they would abandon reelection plans.
HB 4081 would have required pharmacists to offer naloxone or a similar drug whenever a patient filled a prescription for opioids containing 90 morphine milligram equivalents or more, or if the patient has an active prescription for a benzodiazepine like Ativan or Valium and is filling any opioid prescription. Opioids and benzodiazepines are especially dangerous when mixed.
The bill Prusak pursued last year would have required doctors to offer naloxone. It drew opposition from the Oregon chapter of the American College of Emergency Physicians, which argued that other forms of treatment were better than offering naloxone, and that most overdoses were caused by illegal fentanyl and methamphetamine.
“Physicians don’t like to be told what to do,” said Prusak, who is a nurse.
This time, she wrote the bill to focus on pharmacists.
There are 14 other states that have co-prescription laws similar to HB 4081, Prusak says. Most states, including New Mexico and New York, require doctors to offer or co-prescribe naloxone, she says. Colorado passed a law in 2015 that lets pharmacists offer the drug without a prescription.
Passing bills in the 35-day short session is difficult because legislators are limited to the number of bills they can press for passage.
Though frustrated, Prusak says she understands. “The Legislature is charged with addressing a broad range of issues, and we have taken up many this session,” she said in an email. “It is important to remember there are many competing needs in our state and comparing them does not always make sense because they are so different.”