April 22, 2021

Manchin, Scott Bill To Allow For Patients To Decide If They Are Treated With Opiods

Washington, DC – Today, U.S. Senators Joe Manchin (D-WV) and Tim Scott (R-SC) introduced the bipartisan Non-Opioid Directive (NOD) Act, which would establish a non-opioid directive form that allows patients to notify health professionals that they do not wish to be treated with opioids. The NOD Act is based on legislation that has already passed in multiple states.

“Every West Virginian has been impacted by the opioid epidemic that has ravaged our state and our people. Communities across the Mountain State continue to combat this crisis that threatens many of our fellow Americans and West Virginians,” said Senator Manchin. “Our bipartisan bill will help give patients control over their own treatment by allowing them to notify their doctors if they don’t want to be treated with opioids. This will allow for patients in recovery to avoid a relapse, and creates patient choice if they don’t want to risk taking these potentially addictive medicines. I am proud to introduce this legislation that will save lives by reducing opioid related deaths, and I encourage my colleagues on both sides of the aisle to support this commonsense bill.”

Last night, Senator Manchin delivered remarks on the Senate Floor urging Congress to pass his bipartisan bill, FIGHT Fentanyl Act, which would permanently reschedule fentanyl and fentanyl related substances.

“The opioid epidemic has affected the lives of nearly every family in this country, and throughout the pandemic it has only gotten worse,” said Senator Tim Scott. “In South Carolina, we saw a 50% increase in suspected overdoses during the height of COVID last year. Our bill gives patients greater autonomy in choosing non-opioid alternatives and is yet another tool to combat this growing threat and strengthen our health care system for years to come.”

According to the National Institute on Drug Abuse, nearly 50,000 people in the U.S. died from opioid involved overdoses in 2019. That same year, an estimated 10.1 million people aged 12 or older misused opioids. Specifically, 9.7 million people misused prescription pain relievers. The Centers for Disease Control Prevention estimates that the total “economic burden” of prescription opioid misuse alone in the US is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal involvement. The COVID-19 pandemic has just exacerbated this, with an expected 30% increase in overdose deaths for 2020, primarily driven by opioids and synthetic-opioids such as fentanyl.

Key highlights of the NOD Act below:

  • Instructs the Department of Health and Human Services (HHS) to develop a non-opioid Pain Management Directive that will be included in a patient’s medical record.
  • It is voluntary. An individual may revoke a non-opioid pain management form executed by themselves at any time and in any manner. A guardian or patient advocate may also revoke the form for a minor at any time and in any manner.
  • Requires each group health plan or health insurance issuer to make the form available to each enrollee; and requires each group health plan or health insurance issuer to include a notice of the individual’s choice for non-opioid pain management to healthcare providers.
  • Requires group health plans and health insurance issuers to provide a copy of the non-opioid pain management form during annual enrollment, specifically asking the individual to opt-in or opt-out.
  • Allows an exception for providers to override the directive in the event a patient is receiving emergency treatment in a hospital or outside of a hospital; or receiving the opioid through intraoperative use during surgery; and in the treating healthcare professional’s opinion, after due consideration of other options and inquiring about a history of opioid use, the administration of the opioid is medically necessary to treat the individual.
  • The legislation extends full liability protections (criminal and civil) for providers who mistakenly administer an opioid when a patient has signed a directive or for failing to administer or prescribe an opioid. 

Background information on the NOD Act can be found here.

Bill text can be found here.