Curbing the supply of excess opioids prescribed by doctors is a key step in addressing the state’s opioid crisis. Lawmakers should limit initial opioid prescriptions as part of a multifaceted approach to combat this epidemic.
Too many people’s journey to opioid addiction began with a prescription they or someone else received legally from a doctor. Though street drugs such as heroin and fentanyl are increasingly fueling today’s opioid epidemic, the crisis emerged from years of doctors overprescribing pills that pharmaceutical companies falsely marketed as less-than-addictive.
Clamping down on the opioid crisis, which now claims the lives of about 700 Washingtonians annually, shouldn’t cause cancer patients or others with chronic pain to suffer needlessly. But it must involve cutting down on the number of excess pills cluttering the medicine cabinets of American homes — prescriptions that can easily be shared, stolen or misused.
To that end, State Attorney General Bob Ferguson is backing a proposal to limit initial prescriptions of opioids to a three-day supply for those under 21, and a seven-day supply for those 21 and older. State Rep. Eileen Cody, one of the plan’s legislative sponsors, said the rules are designed to target a doctor’s initial prescription for acute pain, such as for those recovering from surgery. Patients with cancer or who are in palliative care or hospice would be exempt, while refills would remain an option.
This step is key to curbing the supply of prescription opioids in our communities. Research has found at least two-thirds of patients don’t take all the opioids they’re prescribed after surgery, and 40 percent of adults who abused opioids without a prescription say they got the drugs free from family or friends.
The Centers for Disease Control and Prevention now recommend doctors prescribe the lowest doses of opioids possible to treat acute pain, noting that three days or less “will often be sufficient” and “more than seven days will rarely be needed.” Requiring doctors to follow these guidelines is a logical step for Washington state lawmakers.
Another sensible change Ferguson proposes is to require doctors to check a person’s prescription history before prescribing them opioids. The state has a prescription-monitoring program that collects records of when patients receive opioids and other controlled substances. But, according to Ferguson’s office, right now only 30 percent of doctors are registered to use the prescription-monitoring system.
Making the database checks mandatory would help curb the practice of “doctor shopping,” when patients visit several doctors to try to feed their addiction. To make these checks easier, the state should provide assistance in integrating the prescription-monitoring database with the electronic medical record systems already used by physicians.
Some of these proposals are already under discussion through an agency rule-making process involving the Department of Health and medical professionals. But without legislative action, nothing guarantees the measures will be enacted quickly, or adopted into the final rules at all.
Ferguson says the opioid crisis is one that can’t wait. He’s right. Lawmakers should adopt some version of these reforms during their 2018 session.
While regulating the flow of prescription drugs from doctors’ offices won’t eliminate opioid addiction by itself, it is an important part of the multifaceted approach policymakers must pursue to combat a crisis that has already taken too many lives.