Monday May 22nd 2017

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State Opioid Laws & Prescribing Limits

Should State Lawmakers Limit Opioid Prescriptions?

Possibly.

As the death toll from opioid overdoses continues to escalate, lawmakers are proposing legislation to limit opioid prescriptions for treating acute pain. In most cases, opioid prescriptions are limited to either a 3 or 7 day limit depending on the state.

Some physicians are relieved to have these restrictions in place so they have a valid excuse for not prescribing opioids to patients who demand them. Others believe these restrictions will affect patient care by physicians being burdened with repeated appointments for refills.

Here, we’ll take a look at the current landscape. I’ll review some basic guidelines and lessons learned. Finally, I offer some insight into how the laws might create new markets for illegal drugs…and new problems. More from former DEA agent and Drug Diversion expert, Warren Rivera, here. Then, we invite your questions or comments at the end. We try to respond to all questions personally and promptly!

State Legislations That Currently Limit Opioids

Legislators are taking notice of the opiate epidemic in the United States and are huddling to create new laws to limit opioid prescriptions. Some states that have already enacted legislation to limit opioid prescriptions are:

  • Connecticut
  • Maine
  • Rhode Island
  • Virginia

Ohio is currently seeking legislative approval to limit opioid prescriptions to 7 days. Prescribing physicians must also complete eight hours of training on opioids and addiction as well as provide addiction treatment in Ohio. Other states are requiring mandatory continuing medical education relative to addiction disorders in addition to limiting opioid prescriptions.

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Kentucky is another state that recently enacted legislation to limit opioid prescriptions to a 3 day supply in treating acute pain. Louisiana is in the process of enacting legislation to limit initial opioid prescriptions to 7 days. It seems that this trend is contagious and will likely continue in all states, particularly if the outcome shows a reduction in opioid overdoses.

Opioid Abuse Creates the Need for New Laws

According to the American Society of Addiction Medicine, 2 million Americans ages 12 or older had a substance use disorder involving prescription painkillers in 2015. According to the Center for Disease Control and Prevention (CDC), more than 33,000 individuals died from opioid overdoses in 2015, the year which the most recent data is available. The CDC also estimates that 91 Americans die each day from overdoses deaths from opioid painkillers or heroin.

Physicians are on the front line of this opiate crisis and are being forced – through legislation -to reduce the amount of opioid prescriptions written for pain not associated with cancer or terminal illness. So will limiting opioid prescriptions reduce the number of deaths from accidental overdose? It appears logical since there will be less opioids available for diversion and abuse. Limiting opioid prescriptions is a step in the right direction to combat this opioid epidemic.

What About Chronic Pain Patients?

What about individuals suffering from chronic pain? The new legislation in most states does not limit opioid prescriptions for chronic pain patients. In some cases, patients being treated for acute pain may also be exempt from the 3 or 7 day limit. For example, the proposed law in Louisiana would allow for individual exemptions for acute pain when medically appropriate with a note in the patient’s record indicating that a non-opioid alternative was not appropriate.

But Laws Create New Drug Diversion

Individuals addicted to opioids who are no longer able to obtain pain pills from a physician often turn to the streets to find a new source for their fix. Addicts need to remain hyper-vigilant due to the extreme amount of lethal fentanyl being sold on the street. Keep in mind the drug dealers could care less about the well-being of their customers.

The drug dealers are in it for one reason.

Profit.

Dealers are selling counterfeit oxycodone pain pills that are actually composed of clandestinely produced fentanyl. The death toll in America is rising due to this phenomenon.

Should Laws Limit Rx Painkillers?

So should the law limit opioid prescriptions? If this new legislation limiting initial opioid prescriptions will reduce the overall number of deaths associated with abuse of opioids, then all states should follow suit.

However, the legislation should allow physicians to continue to prescribe opioids in situations when they believe it is medically necessary as long as the reasons are documented in the patient chart. This legislation also creates heightened awareness in prescribers about the dangers of opioid abuse and diversion. It is burdensome for physicians to have mandatory training and more frequent refill appointments for patients who are prescribed opioids, but if it saves lives, it is worth it.

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About the Author: If you would like to learn more illegal drug trends, how to prevent the diversion of pharmaceuticals or receive training from a retired DEA Special Agent Drug Diversion Expert Warren Rivera, please visit www.trainingidea.com or https://www.linkedin.com/in/warren-rivera-aa4a3221

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Reference Sources: Cleveland: New Ohio rules limit some opioid prescriptions to 7-day supplies
Cleveland: Ohio lawmakers push opioid prescription restrictions, online addiction counseling
ACP Internist: States aim to limit opioid prescriptions
ASAM: Opioid Addiction – 2016 Facts & Figures
Hospitals & Health Networks: 6 Ways Kentucky Is Aiming to End the Opioid Scourge in 2017
Louisiana: Gov. Edwards Releases Legislative Agenda that Advances Family Values

Leave a Reply

One Response to “State Opioid Laws & Prescribing Limits
Christopher
5:42 pm May 2nd, 2017

In the last year I have found it increasingly difficult to fill my monthly prescription of Oxycontin. It is not uncommon for me to have to call several different pharmacies to find one that has the medication in stock. Some months I have to wait days until a pharmacy receives a shipment of Oxycontin. The Kmart pharmacy does not even carry Oxycontin any more. It seems as if patients with legitimate chronic pain are being put in a situation of suffering due to the increased legislation and scrutiny. I firmly believe that there is an opioid abuse epidemic going on in the United States, but the measures being taken are making it progressively more difficult for chronic pain patients to get their legally and medically needed medications.

About Warren Rivera

Warren Rivera is a retired Assistant Special Agent in Charge from the U.S. Drug Enforcement Administration. Mr. Rivera is an experienced public speaker, trainer and an expert in the diversion of pharmaceutical controlled substances. Mr. Rivera currently owns Training Idea, LLC, a private consulting firm that provides training on DEA matters to the healthcare industry, law enforcement and the community.

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