New Calif. bill seeks to embrace pain treatment alternatives to opioids

A new bill seeks to promote alternatives to addictive prescription drugs in managing pain.

Will California lawmakers embrace alternatives to opioid pain management and buck the state’s powerful medical lobby in the process?

A new bill from Asm. Mike Gipson (D–Carson) would seek to offer a wider array of treatment options for Californians in pain, but has managed to attract stiff opposition from powerful interests.

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The big picture: Assembly Bill 1751 aims to combat the opioid crisis in California by requiring prescribers to discuss the availability of nonpharmacological treatments for pain with patients before directly dispensing or issuing a prescription for a controlled substance containing an opioid.

  • The Gipson-led bill would extend this requirement to all patients, not just minors, and would remove the exception for patients being treated for chronic intractable pain.
  • The prescriber would also be required to offer a referral for nonpharmacological treatments for pain, as deemed appropriate by the prescriber, and to obtain consent from the patient or authorized adult.
  • Supporters of the bill argue that it is a necessary step in combatting the opioid crisis and promoting the use of nonpharmacological treatments for pain.
  • The bill would also require coverage of nonpharmacological treatments for pain to be considered during the next update to the state’s essential health benefits benchmark plan for health insurance coverage under the Affordable Care Act.

The backstory: AB 1751 was introduced in response to the devastating impact of the opioid crisis on communities in California, which has prompted an urgent discussion about the risks of addiction associated with overreliance on prescription medication for pain management.

  • The opioid crisis has led to a growing body of research indicating that certain nonpharmacological therapies are proven to be equally effective in treating certain causes of pain as prescription opioids, without placing patients at risk for addiction or overdose.

The other side: The powerful California Medical Association has urged legislators to oppose the bill, arguing that it would interfere with the doctor-patient relationship and limit physicians’ ability to make individualized treatment decisions.

  • The CMA also expressed concerns about the potential for increased costs associated with nonpharmacological treatments for pain and the lack of clarity around what types of treatments would be covered.
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