HR 105
Page 1
Date of Hearing: June 25, 2024
ASSEMBLY COMMITTEE ON HEALTH
Mia Bonta, Chair
HR 105 (Dixon) – As Introduced June 10, 2024
SUBJECT: Opioid Abuse Awareness.
SUMMARY: Requests the Governor, the California Health and Human Services Agency, the
Department of Health Care Services (DHCS), Department of Corrections and Rehabilitation, and
other relevant state entities to further prioritize increasing public and provider awareness of the
health risks associated with opioid abuse. Requests DHCS to increase public and provider
awareness of non-opioid pharmacological therapies to treat pain. Encourages the health care
community to educate themselves and their patients as to the societal, fiscal, and health benefits
of non-opioid therapies to treat pain. Encourages state agencies, within existing resources, to
pursue opportunities and collaborate to protect access to non-opioid alternatives for people or
entities providing, assisting, seeking, or obtaining such non-opioid alternatives for the treatment
of pain in California. Makes findings and declarations including that the opioid crisis has
devastated communities within California, that the federal Centers for Disease Control and
Prevention (CDC) issued updated guidance emphasizing that non-opioid therapies are at least as
effective as opioids for many common types of pain, and that awareness of and access to non-
opioid pharmacological treatments for pain are vitally important to California’s efforts to combat
the opioid crisis, and use of these treatments should be considered by doctors when addressing a
patient’s pain.
FISCAL EFFECT: None.
COMMENTS:
1) PURPOSE OF THIS RESOLUTION. According to the author, the opioid crisis continues
to plague California. The author continues that many of those addicted to illicit and
extremely harmful drugs, first began their dependence on drugs with a legal prescription for
opioids to treat acute pain. The author argues that as medical science continues to evolve, and
new non-opioid treatments become accessible, the state’s health agencies and our medical
professionals should be educated on their availability and use. The author concludes that pain
is very real for many patients, and providing non-opioid pharmacological treatments for them
is an important component of stemming the tide on the opioid crisis.
2) BACKGROUND. California is facing an overdose epidemic. According to a 2022
California Health Care Foundation report “Substance Use in California: Prevalence and
Treatment,” 9% of Californians have met the criteria for a substance use disorder (SUD).
While the health care system is moving toward acknowledging SUDs as a chronic illness,
only about 10% of people with a SUD within the last year received treatment. Overdose
deaths from both opioids and psychostimulants (such as amphetamines), are soaring. This
issue, compounded by the increased availability of fentanyl, has resulted in a 10-fold increase
in fentanyl related deaths between 2015 and 2019.
a) Fentanyl. Fentanyl is a potent synthetic opioid drug approved by the United States (US)
Food and Drug Administration for use as an analgesic and anesthetic. It is approximately
50 times stronger than heroin and 100 times stronger than morphine. First developed in
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1959, it was introduced in the 1960’s as an intravenous anesthetic. Fentanyl is legally
manufactured and distributed in the US; however, there are two types of fentanyl:
pharmaceutical fentanyl and illicitly manufactured fentanyl. Both are considered
synthetic opioids. Pharmaceutical fentanyl is prescribed by doctors to treat severe pain,
especially after surgery and for advanced-stage cancer. Most recently, cases of fentanyl-
related overdoses are linked to illicitly manufactured fentanyl that is distributed through
illegal drug markets for its heroin-like effect. It is often added to other drugs because of
its extreme potency, which makes drugs cheaper, more powerful, more addictive, and
more dangerous.
b) CDC Guidance on Non-Opioid Therapies. In November 2022, the CDC released their
“Clinical Practice Guideline for Prescribing Opioids for Pain,” providing guidelines for
clinicians providing pain care for patients 18 and over. The guidance states that non-
opioid therapies are at least as effective as opioids for many common types of acute pain.
The guidance further states that non-opioid therapies are preferred for subacute and
chronic pain. Non-opioid therapies can be pharmacologic, such as topical or oral non-
steroidal anti-inflammatory drugs, or non-pharmacologic, such as ice, heat, exercise
therapy, and acupuncture. The CDC recommends that clinicians should maximize use of
non-pharmacologic and non-opioid pharmacologic therapies as appropriate and only
consider opioid therapy if benefits are anticipated to outweigh risks to the patient. The
CDC continues that before starting opioid therapy, clinicians should discuss with patients
the realistic benefits and known risks of opioid therapy, should work with patients to
establish treatment goals for pain and function, and should consider how opioid therapy
will be discontinued if benefits do not outweigh risks.
REGISTERED SUPPORT / OPPOSITION:
Support
California Life Sciences
Opposition
None on file.
Analysis Prepared by: Riana King / HEALTH / (916) 319-2097