Testimony of Peter Michaud, J.D., R.N., of the Maine Medical Association

In Opposition to LD 479,

An Act to Inform Patients of the Dangers of Addicting Opioids

Joint Select Committee on Health & Human Services

Room 209, Cross State Office Building

Tuesday, April 11, 2017, 1:00 p.m.

Good afternoon Senator Brakey, Representative Hymanson, and Members of the Committee on Health and Human Services, my name is Peter Michaud. I live in Readfield, and I am testifying today on behalf of the Maine Medical Association (MMA) in opposition to LD 479, An Act to Inform Patients of the Dangers of Addicting Opioids.

The MMA is a professional association representing more than 3,800 physicians, residents, and medical students in Maine whose mission is to support Maine physicians, advance the quality of medicine in Maine, and promote the health of all Maine citizens. We represent physicians from all medical specialties, as well as public health and primary care.

Without a doubt, the intent of this bill is very positive. We want patients to know if a medication they are being prescribed has the potential of being addictive, or in other words, that the patient has the risk of developing a substance use disorder.

But this bill is unnecessary micromanagement of medical practice. Before passing a law with this mandate, we should ask ourselves a question: Is there any evidence that patients are not being informed of such risks?

Informed consent is one of the basic requirements of the physician-patient relationship. It is part of the standard of care. Informing a patient of the risks of using a medication, including but not limited to the risk for addiction, is only a small part of the much larger professional obligation physicians owe their patients. According to the American Medical Association (AMA), informed consent includes the following, when medically appropriate:

· The patient’s diagnosis

· The nature and purpose of the proposed treatment

· Risks and benefits of the proposed treatment

· Alternative treatments

· Risks and benefits of alternative treatments

· Risks and benefits of not receiving a treatment

This bill seeks to mandate actions that are already part of the professional duty. Would a legal mandate accomplish any more than is already there?

There are times when discussing a risk of addiction would not be appropriate. When a patient is dying of cancer and has but a few days or weeks to live, is it beneficial to warn of a risk for addiction?

The bill also seeks to add an additional paperwork obligation, the obligation to “receive from the patient a written certification that the patient has been provided that information.” What information, and in what form? Occasionally this is simple, but often it is not. Does the written certification have to list each risk discussed? Do we want Maine law to mandate communication (and certification) of each benefit, too? What about potential side effects? How common do they have to be? This is unnecessary micromanagement.

Thank you for considering the MMA’s perspective on LD 479, a bill that would mandate that physicians do what they already do and would create additional paperwork burdens. I respectfully ask you to vote the bill “Ought Not to Pass.” I would be happy to respond to any questions you may have.