N.J. doctors question new regulations in anti-heroin bill

TRENTON - As New Jersey legislators consider how to confront a growing heroin and prescription drug epidemic, doctors and medical organizations warned Thursday that newly proposed regulations on physicians and pharmacists could backfire.

A bill advanced Thursday by the Assembly Judiciary Committee would strengthen penalties for prescription drug abuse, provide law enforcement agencies with greater access to prescription monitoring information, and require a state medical board to devise clear standards for prescribing the drugs.

Health-care professionals said those were mostly worthy goals, but chafed at a provision that would require doctors and pharmacists to check a state database for signs of abuse before they prescribe or dispense drugs.

Specifically, they would have to consult the state's Prescription Monitoring Program to determine whether patients had received drugs from other doctors or pharmacies.

Supporters of the program, including a state commission that studied the issue, say greater participation is needed to make the database a useful resource.

The program is voluntary. Less than 18 percent of eligible health-care professionals had registered for it as of February, according to a state task force report on heroin and opiate use released in March.

"By making it more onerous on physicians in many cases to be able to prescribe medications, you're pushing doctors away from being willing to do this," Michael W. Shore, a Cherry Hill psychiatrist who treats addiction, told the Assembly panel.

Lawmakers should focus on drug prevention, education, and treatment, he said.

Proposals like the one before the Legislature "may result in some reduction in some irresponsible prescribing by physicians and possibly less abuse of certain opioids, but what is not at all clear is whether they will result in an overall reduction of opioid use and mitigation of the harms caused by opioid abuse," Roseanne Scotti, state director of the Drug Policy Alliance, said at the hearing.

She cited a 2012 study in the New England Journal of Medicine that found the introduction of a reformulated OxyContin resistant to abuse reduced dependence on that drug among respondents but that their use of heroin doubled.

New Jersey data show a steady rise in prescription drug abuse in recent years.

There were 8,300 admissions to state-certified substance-abuse treatment programs due to prescription drug abuse in 2012, a 200 percent increase over the previous five years, according to the task force report.

A July 2013 report by the State Commission of Investigation - whose recommendations form the basis for the pending legislation - described an epidemic of prescription pill and heroin abuse in New Jersey. Fifteen people in Camden County suffered heroin overdoses on one day in March; all lived.

The state has taken other steps to combat the crisis. Last month, Gov. Christie announced a pilot program to equip police in Ocean and Monmouth Counties with the drug Narcan, which can reverse the effects of a heroin overdose.

Assemblyman Joseph Lagana (D., Bergen), a sponsor of the bill that advanced Thursday, said his proposal was not intended "to tell doctors how to practice, to tell pharmacies how to dispense."

The bill, which passed on a 3-0 vote with two abstentions, "won't wipe out what we're seeing," he said during the hearing. "But implementation will certainly cause people to open their eyes."

Mishael Azam, chief operating officer and senior manager of legislative affairs for the Medical Society of New Jersey, said it was important to strike a balance between ensuring patient access to medicine and working to reduce addiction.

"Are we tipping the scale too much so that we're overregulating?" she asked.

The legislation must pass the full Assembly and Senate before it would head to Christie. A similar bill, which does not include the monitoring program provision, also is being considered.