Dr. Jonathan Fielding

Dr. Jonathan Fielding served as Director of Public Health and Health Officer for Los Angeles County.

The opioid epidemic facing our state is one of the worst healthcare crises California has ever seen. This may be a national epidemic, but it’s hitting home hard.

Currently, California hospitals treat roughly one overdose every 45 minutes due to heroin or prescription painkillers such as OxyContin, Vicodin and Percocet. In 2014, California had the largest number of overdose deaths of any state in the country: 4,521 of our sons, daughters, and loved ones lost.

In Kern County, between 2011 and 2013, 131 people have died of opioid overdoses. Another 1,112 ended up in hospital emergency rooms for opioid overdoses and opioid-related emergencies.

As the Director of the Los Angeles County Department of Public Health, I saw the tremendous toll that addiction takes on families throughout our state every day. Prince’s tragic death due to an overdose on the powerful opioid fentanyl serves as a reminder that no one is immune to this epidemic.

One of the major contributors to this crisis is the systemic overprescribing of painkillers. So why aren’t all of the doctors calling for immediate action to stop this epidemic in its tracks? My physician peers are being hamstrung by their professional organization, the California Medical Association (CMA), which has opposed legislation that would reverse overprescribing.

A bill by California State Senator Ricardo Lara, D-Los Angeles, would require physicians to check the state's prescription drug database (or PDMP) prior to prescribing an opioid and annually thereafter to monitor for harmful drug combinations. Checking a patient’s prescription history is a solution that works, can save lives, and lead to a better level of care for patients.

It’s time for California to take decisive action against this preventable problem, or thousands more families will be shattered.

PDMPs, when fully utilized, equip doctors with the information necessary to prescribe painkillers safely. Doctors can review a patient’s history to ensure they are not prescribing a drug that could be lethal in combination with another medication the patient is currently taking. They can also make sure someone isn’t “doctor shopping” and receiving an unsafe number of prescriptions from multiple doctors.

Currently in California, prescribers are not required to use the technology, rendering it almost useless – like offering a seatbelt in a car but not mandating drivers and passengers use it.

Unfortunately, the California Medical Association is not supporting this life-saving bill. It has proposed a series of proposed amendments that would at best reduce its effectiveness and could even prevent its passage. Their concerns have not been justified by the real world experience of similar successful programs in numerous other states.

Rather, these other programs have proven the success of the approach embodied in Senator Lara’s bill. After a comparable program began in New York, doctor shopping decreased by 75 percent and the number of doses of opioids dispensed decreased by 10 percent. Similar measures enacted in Tennessee and Kentucky led to dramatic improvements in prescribing patterns in those states. In recent months Connecticut, Wisconsin, Massachusetts, Ohio and Maryland passed requirements for doctors to check their state database before prescribing opioids. Modeled off these successful programs, mandating the use of California’s PDMP is a commonsense solution.

Shatterproof, a national nonprofit organization focused on ending addiction, recently released a comprehensive report calling on state legislatures to require doctors to use prescription databases, including 12 best practices for states to use when drafting laws.

I’ve dedicated my life to disease prevention. I’ve seen ideas that work and ones that fail. I believe strongly, and the facts demonstrate, that PDMPs work.

I urge the Business and Professions Committee and the Assembly to pass the strongest and most effective bill possible. Please act to save lives and protect families.

 

Dr. Jonathan Fielding served as Director of Public Health and Health Officer for Los Angeles County for over 16 years. He is currently a Professor of Health Policy and Management, and Pediatrics at UCLA and serves on the Board of Shatterproof, a national non-profit organization focused on ending addiction.