Saying the American medical system is flooded with too many prescription painkillers, governors, lawmakers and health officials are trying to come up with ways to cut down on the amount of pills that reach the hands of patients.
It’s part of the all-of-the-above strategy to combat the opioid epidemic, joining treatment and public awareness campaigns.
The idea, backers say, is to push doctors to make smarter choices about prescriptions.
Rep. Mark Meadows, North Carolina Republican, recently introduced bill that would limit initial opioid prescriptions for acute pain to seven days, except in cases of traumatic injury, chronic conditions or a doctor’s specific recommendation.
“Most addictions start after the seventh day. And a lot of times when physicians do a surgery, they just do a 30-day prescription,” Mr. Meadows said.
Those remaining 21 days are a concern, since too many Americans unwittingly get hooked on prescription opioids and — in some cases — later turn to cheaper heroin.
Mr. Meadows, a small-government conservative, said he worked with physicians to draft the legislation in a way wouldn’t tread on doctor-patient relationships or cut off appropriate treatment.
“I don’t want to have the long arm of government coming in,” he said. “It just provides a touchback between the patient and the doctor that hopefully will keep some of these people from overdosing.”
Sen. John McCain, meanwhile, wrote a bill with Sen. Kirsten Gillibrand, New York Democrat, that — like Mr. Meadow’s bill — would limit the first fill of opioid medication to just seven days if a patient is being treated for something minor, like a wisdom tooth extraction.
The effort mirrors executive actions taken by their home-state governors to limit an initial fill of painkiller pills.
Lawmakers from across the nation say they’re concerned that too many constituents are receiving opioids they don’t need.
Rep. Raja Krishnamoorthi, Illinois Democrat, said he once spoke to a mother whose 7-year-old son was given a month-long supply of Vicodin for a minor surgery. When she realized he didn’t actually need the pain pills after a day or two, she was surprised to hear the child retort, “But I need it.”
“We should not be prescribing such powerful medicines for young people, and really for a lot of people,” the congressman said.
The Trump administration is eyeing moves that would complement Congress’ push to limit the use of opioids in cases where it isn’t truly necessary.
Food and Drug Commissioner Scott Gottlieb, in a recent speech on opioids said there is over-prescribing of opioids for short-term pain.
“Why couldn’t a three-day course of treatment be sufficient for a first dispense, or a trial of ibuprofen?” he told a workshop on the issue in Silver Spring, Maryland.
The DEA, meanwhile, was applauded by Sen. Richard J. Durbin, Illinois Democrat, for reducing production quotas for various opioid drugs. The agency slashed production for the second year in a row, after a large-scale proliferation of the drugs during the past two decades.
Prescriptions shot up from 76 million in 1991 to more than 245 million in 2014, Mr. Durbin noted, and overdoses also skyrocketed.
Outside experts say greater scrutiny of the quantity of pills being prescribed is a good idea.
“Changing the formulation of opioid pills might also help,” said Richard Ausness, a law professor at the University of Kentucky who tracks the issue. “However, I am not sure any of this will have a beneficial effect on those who are already addicted. There is some evidence that some of them are turning to other drugs, like heroin, as the supply of prescription opioids dries up.”
Policymakers say they’re trying to stamp out problems in the illicit market, too. Opioids such as fentanyl are flooding the illicit drug market and driving the steady increase in opioid-related overdose deaths.
The White House’s commission on opioids recommended stiffer federal sentences for traffickers of fentanyl, while Congress is mulling legislation — known as the STOP Act — that would require foreign postal systems to send advanced electronic data on what’s in packages, so agents can better target ones that may contain narcotics.
“Right now we are seeing the largest number of deaths in Ohio coming from fentanyl and synthetic drugs, which is why we have focused on the STOP Act to help stop the flow of these drugs into the United States,” Sen. Rob Portman, Ohio Republican, who crafted the bill. “I’m hopeful we see legislative action on this bill next year.”
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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