SACRAMENTO, Calif. (AP) — An appeals court has formally ended a lawsuit that in 2018 temporarily suspended a California law that allows adults to obtain prescriptions for life-ending drugs, a gap that advocates blamed Thursday for a significant drop in its use that year.

California lawmakers made the lawsuit moot last month when they reauthorized and extended the law until 2031 while reducing the time until terminal patients projected to have six months or less to live can choose to be given fatal drugs.

The 452 terminally ill Californians who received prescriptions in 2018 was down 22% from the previous year, when 577 people received the lethal drugs, before increasing to 618 who obtained the drugs in 2019.

Last year, 667 people obtained prescriptions. In each year, not everyone who received the drugs used them to end their lives.

Compassion & Choices, a national organization that advocated for the law, blamed the drop three years ago on a Riverside County judge's ruling in May 2018 that state legislators acted unconstitutionally when they passed the law during a special session that was devoted to health care in 2016.

Superior Court Judge Daniel Ottolia's suspension was in place about three weeks before an appeals court reinstated the law.

But the advocacy group said at the time that the ruling interrupted the plans of about 200 patients who had already started the process, while causing confusion and fear among both doctors and patients about violating the law.

A different Riverside County judge last year ruled that lawmakers in fact did act properly and that physicians who sued to block it lacked legal standing to file the challenge. But the court allowed the opponents to refile their complaint if they could find patients to join the lawsuit.

Late last week the two sides agreed that the Legislature's recent reauthorization and extension of the law, which had been set to sunset in another five years, effectively ended the legal challenge. The 4th Appellate District Court of Appeal accepted the parties' stipulation in a one-paragraph order Monday, without comment.

Starting January 1 under the reauthorized law, the waiting period required between the time a patient makes separate oral requests for medication will drop to 48 hours, down from the current minimum 15 days.

The revised law also eliminates the requirement that patients make final written attestations within 48 hours of taking the medication. 

The Life Legal Defense Foundation, which represented opponents in the lawsuit, did not immediately comment Thursday.

“We always believed the California legislature lawfully passed the End of Life Option Act during a special session on healthcare because medical aid in dying is a palliative care option to relieve intolerable suffering,” Compassion & Choices chief legal advocacy officer Kevin Díaz said in a statement. “But thanks to the Legislature reauthorizing the law this year during a regular session, it doesn’t matter anymore.”

California is one of 10 states and Washington, D.C. that allow medical aid in dying. The others are Colorado, Hawaii, Maine, Montana, New Jersey, New Mexico, Oregon, Vermont and Washington state.