Parents in New Jersey must now be informed by a physician about the addictive risks associated with opioid-based pain relievers before the medication is subscribed to their underage children.
The new state law signed Monday by New Jersey Gov. Chris Christie is the first of its kind in the U.S. It's the latest initiative being taken by his administration to address the state's opioid abuse epidemic, which has killed more than 6,000 people since 2004.
“Piece by piece, I am proud that my administration, with bipartisan cooperation from the legislature, is creating a holistic model for America to curb this epidemic impacting all residents, families, communities and businesses,” Christie said in a statement.
Under the law, prescribers must discuss with a parent of a patient under the age of 18 about addictive qualities related to Schedule II controlled substances—medications designated by the Drug Enforcement Agency as having a high risk for abuse—prior to prescribing them to a minor patient and, “if the prescriber deems it appropriate,” talk about the use of alternative treatments.
Prescribers must obtain written acknowledgement from the parent or guardian that a discussion took place. That will be noted in the patient's medical record with a form developed by the state's Department of Law and Public Safety. Patients in hospice care will be exempted from the law.
Passage of the bill came as a result of patient and family feedback.
“In fact, in some cases, we've had families who said moms and dads went out and refilled prescriptions for their children because they didn't understand really that the drugs they were being prescribed had a very serious potential for addictive qualities and consequences,” said Angelo Valente, executive director of Partnership for a Drug-Free New Jersey.
Valente hopes the model will encourage both physicians and parents nationwide to make better informed decisions.
Drug overdose is the leading cause of accidental death in New Jersey. The state saw a spike in the rate of overdose deaths between 2014 and 2015, according to the Centers for Disease Control and Prevention, climbing by more than 16% and resulting in more than 1,400 deaths in 2015.
In January, New Jersey Attorney General Chris Porrino used emergency powers to limit the amount of opiate-based pain relievers doctors could prescribe for acute pain from a 30-days' supply to five days, a move that drew criticism by the Medical Society of New Jersey.
Despite the bipartisan support for the bill in its passage, it has received criticism from some members of the medical community.
In a solicited comment to the new law, Ray Saputelli, executive vice president of the New Jersey Academy of Family Physicians, questioned whether the law would have much impact. He believes it would only place another administrative burden on physicians that will interfere with their relationship with patients.
“As family physicians, educating patients about preventive health is something we do every day,” Saputelli wrote.
According to Mishael Azam, COO and senior manager of Legislative Affairs for the Medical Society of New Jersey, state law already had required informed consent for the prescribing of such medications. She hoped more attention would be given to the lack of insurance coverage of opioid alternatives, as well as proper medication storage and disposal to reduce the likelihood of diversion.
Such efforts could have negative consequences if physicians hesitate to treat children for pain out of concerns over potential abuse, said Dr. Rita Agarwal, chair of the American Academy of Pediatricians' Section on Anesthesiology and Pain Medicine.
“Pain needs to be treated,” Agarwal said. “We can't go back to not treating pain in children—that's inhumane and it's not appropriate.”
