SENATE BILL No. 274

 

 

March 23, 2017, Introduced by Senator KNOLLENBERG and referred to the Committee on Health Policy.

 

 

     A bill to amend 1978 PA 368, entitled

 

"Public health code,"

 

by amending section 17744b (MCL 333.17744b), as amended by 2016 PA

 

384, and by adding section 7333b.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 7333b. (1) A prescriber shall not prescribe a patient any

 

of the following:

 

     (a) Except as otherwise provided in subdivision (b), a

 

combination of opioids in an amount that exceeds 100 morphine

 

milligram equivalents per day in the aggregate.

 

     (b) Until June 30, 2018, if the patient has on the effective

 

date of the amendatory act that added this section a prescription

 

for an opioid in an amount that exceeds 100 morphine milligram

 

equivalents per day, an opioid in an amount that would cause the

 

amount of opioids prescribed to the patient by the prescriber to

 

exceed 300 morphine milligram equivalents per day in the aggregate.

 

Beginning July 1, 2018, the amount of opioids prescribed by a

 

prescriber must not exceed 100 morphine milligram equivalents per

 

day in the aggregate.

 

     (c) Beginning July 1, 2018, if the patient is being treated

 

for chronic pain, more than a 30-day supply of an opioid within a

 

30-day period.

 

     (d) Beginning July 1, 2018, if the patient is being treated

 

for acute pain, more than a 7-day supply of an opioid within a 7-

 

day period.

 

     (2) As used in this section:

 

     (a) "Acute pain" means pain that is the normal, predicted

 

physiological response to a noxious chemical or a thermal or

 

mechanical stimulus and is typically associated with invasive

 

procedures, trauma, and disease and usually lasts for a limited

 

amount of time.

 

     (b) "Chronic pain" means pain that persists beyond the usual

 

course of an acute disease or the healing of an injury and that may

 

be associated with an acute or chronic pathologic process that

 

causes continuous or intermittent pain over months or years.

 

     Sec. 17744b. (1) Notwithstanding Except as otherwise provided

 

in subsection (2), notwithstanding any provision of this act to the

 

contrary, a prescriber may issue a prescription for and a

 

dispensing prescriber or pharmacist may dispense an opioid

 

antagonist to any of the following:

     (a) An individual patient at risk of experiencing an opioid-

 

related overdose.

 

     (b) A family member, friend, or other individual in a position

 

to assist an individual at risk of experiencing an opioid-related

 

overdose.

 

     (c) A school board for purposes of section 1179b of the

 

revised school code, 1976 PA 451, MCL 380.1179b.

 

     (d) A person other than an individual that meets all of the

 

following requirements:

 

     (i) Acts at the direction of the prescriber or dispensing

 

prescriber.

 

     (ii) Upon receipt of an opioid antagonist, stores the opioid

 

antagonist in compliance with this part.

 

     (iii) Dispenses or administers an opioid antagonist under a

 

valid prescription issued to an individual or a patient.

 

     (iv) Performs the requirements under this subsection without

 

charge or compensation.

 

     (2) Subject to section 7333b, a prescriber who prescribes a

 

patient an opioid in an amount that exceeds 50 morphine milligram

 

equivalents per day shall also prescribe the patient an opioid

 

antagonist if the prescriber knows that the patient meets any of

 

the following at the time of prescribing the patient the opioid:

 

     (a) He or she has a history of drug overdoses.

 

     (b) He or she has a history of substance use disorders.

 

     (c) He or she is also using a benzodiazepine.

 

     (3) (2) When issuing a prescription for or dispensing an

 

opioid antagonist as authorized under this section to a school

board or a person other than a patient, the prescriber, dispensing

 

prescriber, or pharmacist, as appropriate, shall insert the name of

 

the school board or the person as the name of the patient.

 

     (4) (3) Notwithstanding any provision of this act to the

 

contrary, a person that is acting in good faith and with reasonable

 

care may possess and dispense an opioid antagonist.

 

     (5) (4) Notwithstanding any provision of this act to the

 

contrary, a school employee who is a licensed registered

 

professional nurse or who is trained in the administration of an

 

opioid antagonist under section 1179b of the revised school code,

 

1976 PA 451, MCL 380.1179b, may possess and administer an opioid

 

antagonist dispensed to a school board under this section.

 

     (6) (5) A prescriber who issues a prescription for or a

 

dispensing prescriber or pharmacist who dispenses an opioid

 

antagonist as authorized under this section is not liable in a

 

civil action for a properly stored and dispensed opioid antagonist

 

that was a proximate cause of injury or death to an individual due

 

to the administration of or failure to administer the opioid

 

antagonist.

 

     Enacting section 1. This amendatory act takes effect 90 days

 

after the date it is enacted into law.