Author: Justin Mckibben
Despite the fact that over 91 people die every day from an overdose due to prescription drugs, some people still struggle to realize that prescription drug abuse is the driving force behind the current opioid epidemic. According to the American Society of Addiction Medicine (ASAM):
- 4 out of 5 heroin users started out abusing prescription pain medication
- 94% of people in treatment for opioid addiction surveyed in 2014 switched to heroin from prescription opioids.
One of the biggest issues is that powerful opioid painkillers are being overprescribed. Whether due to aggressive marketing tactics used by Big Pharma companies or the corrupt ‘pill mills’ where doctors were dishing out excessive prescriptions of potent drugs to be sold on the street, prescription opioids flooded the neighborhoods across the nation, helping create one of the worst addiction outbreaks in American history.
But it wasn’t just the fact that drugs were making it onto the streets. In general, even legitimate opioid prescriptions were astonishingly high. While too many people still think the only problem is heroin or street drugs, the facts show us that opioid painkillers were still largely overprescribed in recent years, which contributed to the current crisis.
Too ‘Legit’ to Quit
According to the National Survey on Drug Use and Health, nearly 92 million U.S. adults in 2015 were taking a legitimately prescribed opioid. That translates to 38% of the adult American population.
There were an estimated 240 million opioid prescriptions in 2015, nearly one for every adult in the general population. Even the Deputy Director of the U.S. National Institute on Drug Abuse, Dr. Wilson Compton, said,
“The proportion of adults who receive these medications in any year seemed startling to me”..”It’s an awful lot of people who take these, mostly for medical purposes, but within that, a significant percentage end up misusing them,”
So while a lot of these prescriptions were going to treating serious conditions, how many ended up on the street or being abused at home because they were overprescribed?
The same NSDUH survey found that 11.5 million people misused prescription opioids they obtained through illicit means. Overall, Dr. Compton states that these results indicate medical professionals are doing a poor job of appropriately prescribing these medications.
The trend didn’t end there. According to a new report, nearly 3 million people who had surgery in 2016 became persistent opioid users, taking the drugs 3-6 months after a procedure. The report also states that due to overprescribing, 3.3 billion pills were left unused by patients, which left them open for diversion or misuse.
Some pain management advocates insist that pain may end up being undertreated due to the rising scrutiny of opioid prescriptions. Many of these advocates say it is extremely difficult to truly know if opioids are overprescribed because pain is too hard to objectively quantify. Therefore, some patients may actually need more relief resources than others.
Yet, prescribing rates are still, at the very least, questionably high. Especially considering by most estimates that over 50% of opioid pills legitimately prescribed are unused by patients, which suggests significant overprescribing certainly exists.
4 Doctors, 6 Million Pills, 1 Year
One recent case in particular that stands out concerning overprescribing of medications is the story of a small northwestern county in Arizona where 4 doctors prescribed nearly 6 million opioid pills in a 12 month period. The data provided by the Controlled Substances Prescription Monitoring Program did not list the doctors by name, but did give detailed information about the prescriptions.
Out of all 4, the top prescribing doctor is responsible for:
- More than 20,000 opioid prescriptions
- Equaling out to over 1.9 million pills
- That comes to 7,350 pills a day
The second-place prescriber is responsible for:
- More than 15,000 prescriptions
- Equaling out to nearly 1.6 million pills
The other two doctors totally a combined 2.4 million pills prescribed.
The four doctors in question are located in Mohave County, which as of 2016 is home to approximately only 205,249 people. That comes out to about a 30 opioid supply for every single person in that county.
Now while pain may be hard to objectively quantify, these numbers are obviously unsettling. Even the executive director of the Arizona Board of Pharmacy, Kam Gandhi, could not explain why or how these four physicians were able to issue so many opioid pills.
A spokesperson for Attorney General Mark Brnovich declined to specify exactly what actions are being taken by his office concerning this development. However, according to AZ Central Doug Skvarla, who directs the Controlled Substances Prescription Monitoring Program, said that information has been passed on to Brnovich’s office for “an open investigation.”
Illicit Use of Prescriptions
There are plenty other issues with opioid prescriptions being taken advantage of all over the United States. Pain management advocates often argue that the problem isn’t about opioid prescriptions; it’s the people that misuse and divert the medications. In other words, that the people abusing opioids frequently don’t have a legitimate prescription. A lot of opioid pills being abused are obtained illicitly.
Many people won’t use their whole prescription. Many will actually give pills to a loved one who doesn’t have their own pain treatment. Or they will sell their remaining pills. Pill mills and ‘doctor shopping’ allowed for the even worse spread of excessive opioid prescriptions. Like in Illinois, where one individual received 73 prescriptions for opioid drugs from 11 different prescribers and filed them at 20 different pharmacies. In some cases, the individual filled prescriptions at multiple pharmacies in one day.
There is absolutely a high demand on the illegal drug market for prescription opioid painkillers. As a former addict who spent over 7 years using, buying and selling opioid medications on the street, I can say there is plenty of ways to get these drugs without a prescription.
However, if we back-track a little bit, how did so many potent medications get onto the streets if there is no overprescribing?
Feeling the Pain
Pain management is absolutely necessary. There must be resources and effective medications available for those suffering from serious medical conditions or recovering from life-altering procedures. There is no denying that we have to provide effective pain relief options for patients who desperately need it. So, of course, this is a difficult conversation to have, because many people can take these medications are directed and be fine when they are gone. Some people require long-term pain treatment, but it does not result in a severe addiction.
Still, the fact is that if these medications weren’t being prescribed more than medically necessary, they would have never flooded the underground drug marketplace as rapidly and as abundantly as they did. Between doctors overprescribing (sometimes for kickbacks), patients working the system and manipulating physicians, and the aggressive marketing tactics of Big Pharma going unchecked, there are plenty of elements at play.
Undoubtedly when we examine the opioid epidemic we cannot ignore any contribution. We have to make efforts to combat the spread of heroin addiction. There has to be an intensive effort to deal with the incredibly deadly synthetic opioids like fentanyl and carfentanil, and people also have to acknowledge their own choices and do their part to move forward. It might be a difficult and painful process, but it is necessary.
Still, overprescribing of opioid medications cannot be ignored. We should explore all options concerning prescription monitoring programs, enforce current regulations of drug distribution, and develop innovations in pain management therapy.
According to one report, even just a 10% reduction in surgery-related opioid prescribing would reduce:
- The number of excess post-surgical pills available for diversion or misuse by 332 million
- The annual number of patients who go on to persistent opioid use after surgery by 300,000
- Annual drug costs by $830 million
Not only can we do better to treat those suffering from chronic and severe pain, but we can do better to make sure these potent and habit-forming medications don’t end up in the wrong place. For those who abuse prescription opioids, or who have found themselves using heroin, we need to provide safe and effective treatment options. Palm Partners Recovery Center has been treating people struggling with drug dependence and substance use disorder for decades, focusing on holistic and comprehensive care. If you or someone you love is struggling, please call toll-free now.
CALL NOW 1-800-951-6135
(This content is being used for illustrative purposes only; any person depicted in the content is a model)
Author: Justin Mckibben
You may remember back in early 2016 the pharmacy organization Walgreens announced two programs to address key issues in the opioid crisis.
- Safe medical disposal kiosks for unused prescription drugs
- Narcan expansion programs
By the end of 2016, Walgreens had expanded access to the opioid overdose antidote without the requirement of a prescription to 33 states and the District of Columbia. The Narcan opioid overdose antidote, also known by the generic name Naloxone, is a nasal spray that is utilized all over the country as a means to revive someone experiencing an opioid overdose.
Now, this life-saving compound is becoming even more accessible, as Walgreens is announcing the Narcan opioid overdose antidote will now be available at all of its over 8,000 pharmacy locations!
Pharmacies Stepping Up to the State of Emergency
This new move to combat the opioid epidemic comes at a crucial time. The epidemic continues to claim lives every day, with recovery advocates and government officials rallying for more resources to fight the problem.
Today, Thursday, October 26, 2017, the nation is expecting President Donald Trump to officially declare the opioid crisis a public health emergency at a scheduled White House event.
According to Rick Gates, Vice President of Walgreens,
“By stocking Narcan in all our pharmacies, we are making it easier for families and caregivers to help their loved ones by having it on hand in case it is needed.”
The company offers Narcan opioid overdose antidote without a prescription in 45 states and is willing to work with the remaining states to make to include them.
Of course, the fight for more availability of Narcan and Naloxone has been going on for some time. However, it seems as the country is calling for more sweeping action from government officials; pharmacies are taking it as a call to action themselves. Rick Gates went on to say,
“As a pharmacy, we are committed to making Narcan more accessible in the communities we serve.”
Walgreens also says it will inform customers about the Narcan opioid overdose antidote if they receive drugs with more than 50 morphine milligram equivalents (MME). This is actually a recommendation from the CDC.
It isn’t just Walgreens either. CVS pharmacy has expanded access to Narcan and other products that contain naloxone. CVS reportedly has been offering prescription-free naloxone in up to 43 states as of last month. CVS pharmacies have said that its locations “in most communities have naloxone on hand and can dispense it the same day or ordered for the next business day.”
Big Pharma’s Role
Big Pharma wholesaler AmerisourceBergen is also helping in these efforts. AmerisourceBergen is now distributing Narcan demo devices at no cost to Walgreens pharmacists. These demo devices will help with instructing patients on how to administer the medication safely and effectively.
Robert Mauch, Executive Vice President & Group President, Pharmaceutical Distribution & Strategic Global Sourcing for AmerisourceBergen, states,
“At AmerisourceBergen, we strive to provide our customers the highest quality care and support so they can ultimately enhance the lives of patients in their communities,”
“We recognize the important role we play in addressing the opioid epidemic, and our collaboration with Walgreens is another key milestone to supply our customers with access to lifesaving initiatives and emergency medications that can help keep individuals safe across the country.”
Ironically, AmerisourceBergen just so happens to be one of the three largest drug distributors that were mentioned in the recent 60 Minutes interview with ex-DEA agent Joe Rannazzisi. In the segment that has since caused a major uproar, Rabbazzisi said companies including AmerisourceBergen controlled probably 85%- 90% of drugs that went “downstream” and ended up on the streets.
This might not be what Mauch meant by “recognize the important role we play”, but at least it seems like AmerisourceBergen is taking steps to become part of a solution.
Meanwhile, Adapt Pharma, the manufacturer of Narcan Nasal Spray, celebrates this action by Walgreens to expand naloxone and Narcan access. Seamus Mulligan, CEO at Adapt Pharma states,
“This action is an important milestone and we applaud Walgreens initiatives to improve access to Narcan Nasal Spray in communities across the U.S.,”
“This effort, combined with the opportunity for patients and caregivers to obtain Narcan Nasal Spray without an individual prescription in 45 states, is critical in combating this crisis.”
America is working hard to find the right path on the road to recovery from the devastating opioid crisis. It is crucial that we make every possible resource available to help save lives. With opioid overdose killing an estimated 91 people every day, the need for this life-saving medication could not be more evident.
Beyond reversing the effects of an overdose, there is more we need to do. While having access to Narcan and naloxone can help tremendously, we also need to promote recovery and addiction treatment resources. Preservation of life is important, but giving people the help they need to live a happier and healthier life should also be a priority in the fight to overcome the opioid crisis. Palm Partners Recovery Center believes in actively providing the best in innovative and holistic treatment opportunities, to help transform lives. If you or someone you love is struggling with substance abuse or addiction, we want to help. Please call toll-free now.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
Earlier this week we talked about a story that shook things up in politics as a former DEA agent threw some serious accusations at the Big Pharma industry, Congress and a number of key officials for their involvement in policies some believe helped create the enduring opioid crisis in America. Among those accused of tipping the scales in favor of Big Pharma and stripping power away from those charged with regulating the industry was Republican Representative Tom Marino.
Of course, we know that Tom Marino was President Donald Trump’s top nominee to be the nation’s drug czar.
Now, after withdrawing from the nomination to head the White House Office of National Drug Control Policy, Tom Marino says he is proud of his role in writing a 2016 law that many critics say paved the way for the current epidemic.
The Tom Marino Factor
What kind of role did Tom Marino have in the creation of the Ensuring Patient Access and Effective Drug Enforcement Act? Why is it that so many are up in arms about the bill in the first place?
To recap- Pennsylvania Congressman Tom Marino and Congresswoman Marsha Blackburn of Tennessee introduced a bill to the House. It was advertised to officials as a way to ensure that patients had access to the pain medication they needed. In a statement released by Marino’s office, he claims the law would help “facilitate a balanced solution” by ensuring access to certain medications while allowing the Drug Enforcement Administration to prevent the sale and abuse of prescription drugs.
In essence, Tom Marino was supposedly pushing for a way to let pain management patients still get the useful medications they needed, without impeding on the process of curbing abuse.
But that isn’t how everyone sees it, especially after the 60 Minutes story.
Why it Matters
According to the opposition, the bill ultimately did little else besides weaken the DEA and the government’s authority to stop companies from distributing opioids in suspicious shipments.
For years prior to the passage of the “Marino Bill” some big-time drug distributors were getting fined thousands of dollars for repeatedly ignoring DEA warnings to shut down suspicious sales of hundreds of millions of pills. These companies were racking up billions of dollars in sales while turning a blind eye to obnoxious overprescribing of dangerous drugs.
Back then the DEA was able to immediately prevent drugs from reaching the street by freezing suspicious shipments. If the DEA judged that the drugs posed an “imminent danger” to a community, they could take action to prevent the flood of powerful narcotic medications from overwhelming the area.
However, the Tom Marino bill is argued to make it virtually impossible for the DEA to freeze suspicious narcotic shipments from the companies. Now, the agency is required to demonstrate that a drug distributor’s actions represent “a substantial likelihood of an immediate threat,” which officials say is far more difficult criteria to meet. The report against the Tom Marino bill even cited internal DEA and Justice Department documents and an independent assessment by the DEA’s chief administrative law judge.
The DEA even fought the bill, according to people within the agency, but in 2015 the law gained momentum again when the Justice Department named a new chief of the DEA- Chuck Rosenberg. After some reluctance, the report on 60 Minutes that included exclusive insight from Joseph T. Rannazzisi states the DEA ultimately took a deal they did not want.
Champion for Big Pharma
Marino disputed that, calling the reports “false accusations and unfair reporting.”
Tom Marino spent years pushing versions of this bill through Congress. He argued that it was to put an overly-aggressive DEA in check and protect drug companies from what he believed was unfair or misguided federal interference. In other words, he spent a lot of time fighting for Big Pharma’s ability to send millions of pills to communities that didn’t have half the population to justify them. All because the DEA was being aggressive?
The irony here is that the same people who pushed so hard for drug distributors ability to traffic obscene among of pills without the pesky DEA would probably be the same people demanding mandatory minimums for low-level drug offenders on the streets.
And again, many are still suspicious of those involved in pushing for this kind of legislation because of their connections to Big Pharma industry. The Post reports that the drug industry worked behind the scenes with lobbyists and key members of Congress, including Tom Marino.
Some reports indicate the Big Pharma industry poured more than a million dollars into election campaigns, including Marino’s, who received nearly $100,000 in campaign contributions from political action committees supporting the drug industry.
Utah Republican Senator Orrin Hatch calls the report “complete baloney” after it gained serious momentum earlier in the week.
Why are we not surprised? Because Hatch himself has received hundreds of thousands in donations from Big Pharma companies and health contributors over the years.
Holding Big Pharma accountable for their contribution to the opioid epidemic has become an increasingly popular cause. Lawyers and politicians at all levels have been pushing to put a spotlight on the shady side of the pharmaceutical industry. Now it seems that spotlight may extend more and more to exposing the politics that allow these issues to spread.
Another crucial element to putting an end to the opioid epidemic is providing safe and effective treatment for those who need help the most. A lot of people are still out there suffering because of prescription drug abuse or other dangerous substances. But we want to help. If you or someone you love is struggling, please call toll-free now.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
Ever since the true nature of the opioid epidemic in America began to come to light, and people started to see the gravity of its impact in communities across the country, there have been plenty of efforts to find out how we ever got this far. We continue to ask who should be held accountable. Was it the black market drug trade? Was it the synthetic opioids coming from overseas? How did it get this bad?
Just this past week 60 Minutes and The Washington Post joined forces to interview Joe Rannazzisi, who is said to be the most important whistleblower ever on 60 Minutes.
Joe Rannazzisi is a former agent of the Drug Enforcement Administration (DEA) who ran the Office of Diversion Control; the department in charge of regulating and investigating the pharmaceutical industry. He is a former DEA deputy assistant administrator with a law degree, and a pharmacy degree, who believes the great injustice done to the American people cannot go overlooked.
Bad Business with Big Pharma
Through this inside look with Rannazzisi, he implicates Big Pharma drug makers in willingly distributed hundreds of millions of drugs to rogue pharmacies and pain-clinics-turned-pill-mills for over two decades.
Rannazzisi believes that the Big Pharma companies, some even multi-billion, Fortune 500 companies, have contributed to the problem by ignoring the truth; that powerful prescription pain medications were being diverted from doctors, clinics and pharmacies for illicit use. In the interview, Rannazzisi calls out a number of key drug makers, including:
He also calls out the three largest drug distributors:
- Cardinal Health
Saying they control probably 85%- 90% of drugs “going downstream.”
In fact, Rannazzisi said the way pain clinics seemed to pop up overnight all over the country made the whole crack-cocaine epidemic look like nothing, saying he had never seen anything like it, adding:
“These weren’t kids slinging crack on the corner. These were professionals who were doing it. They were just drug dealers in lab coats.”
Rannazzisi says after prosecuting pain doctors and pharmacists didn’t seem to put a real dent in the problem, he knew he had to work his way up; they went after distributors.
While drug distributors tried to defend themselves saying it was all on the doctors for over-prescribing medications, Rannazzisi says they know exactly how many pills are being sent out. Under the Controlled Substances Act, these distributors are required by law to report and stop what the DEA refers to as “suspicious orders”.
So what might “suspicious orders” look like? Probably something lie unusually large and/or frequent shipments of opioids being made to a location. Kind of like what was happening all over the nation for years and years.
For example, just one pharmacy in Kermit, West Virginia ordered 9 million hydrocodone pills in just over 2 years. That’s for a town of only 392 people. That’s over 11,479 pills a person each year! Almost 1,000 pills a month! From only one of the town’s pharmacies.
DEA investigators say many drug distributors ignored the DEA requirements and shipped anyway.
DEA Fighting Back
Rannazzisi wasn’t the only DEA agent to speak up about Big Pharma’s bad business. Several other DEA veterans say they saw thousands of suspicious orders and tried to fight the growing problem. Others said they tried on multiple occasions to get these companies to fix the issue, but they did nothing.
Eventually, in 2008 the DEA was able to hit some distributors with hefty fines for filing hundreds of suspicious orders, including:
- $13.2 million fine against the country’s largest drug distributor, McKesson
- $34 million fine against second-largest distributor, Cardinal Health
The fines for drug distributors over the last 7 years add up to around $341 million.
The High Rollers
In 2011, Cardinal Health attorneys called Rannazzisi’s boss at the Justice Department, who called Rannazzisi and pressed for an explanation for his policies. Rannazzisi believes that even after they had gone after small companies hundreds of times before, as soon as they went after the Fortune 500 drug makers, their power and influence started getting in his way.
Rannazzisi says that with these massive Big Pharma empires there was now money and influence being used to pressure top lawyers at the DEA to pursue a softer approach on penalizing drug distributors who broke the rules.
Former DEA attorney Jonathan Novak noticed that shocking shift in the way these kinds of cases were handled. Stating:
“These were not cases where it was black — where it was grey… These were cases where the evidence was crystal clear that there was wrongdoing going on.”
But suddenly the higher ups started to demand more and more evidence to stall the system. Fewer cases against Big Pharma companies were being approved, and road-blocks from Novak’s bosses seemed to pop up everywhere.
Novak also said he saw a huge migration of DEA lawyers switching sides to defend the drug industry in higher paying positions.
Taking it to Congress
While drug distributors started successfully stalling the progress of cases against them from the DEA, they also began to lobby Congress to get legislation that would destroy the DEA’s power over them.
Then one day Pennsylvania Congressman Tom Marino and Congresswoman Marsha Blackburn of Tennessee introduced a bill to the House that was promoted as a way to ensure that patients had access to the pain medication they needed. However, Jonathan Novak, who worked in the DEA’s legal office, claims that what the bill really did was strip the agency of its ability to immediately freeze suspicious shipments of prescription narcotics to keep drugs off U.S. streets.
The bill’s author… Linden Barber, a former employee of the DEA.
Congressman Tom Marino, along with Congresswoman Blackburn, later wrote the inspector general for the Justice Department, demanding that Rannazzisi be investigated for trying to quote “intimidate the United States Congress.” Even though this went nowhere, Rannazzisi was stripped of his responsibilities soon after.
Some former DEA agents believe that the Big Pharma industry not only used lobbying groups to donate money to politicians to get laws passed in their favor, but also to try and push Joe Rannazzisi out of his office.
In the end, the DEA signed off on the final version of the “Marino bill.” A senior DEA representative claiming that even though they fought to stop it, growing pressure from Congress and industry lobbyists forced them into a deal it did not want.
The bill was presented to the Senate in March of 2016.
Majority Leader Mitch McConnell introduced the legislation in the Senate.
It passed by unanimous consent with no objections and no recorded votes.
It passed the House the same way, and President Obama signed it into law.
Where Are We Now?
This whole thing reminds you of the saying- if you can’t beat em, join em.
It would seem that’s exactly what a lot of DEA agents did after fighting a losing battle against powerful Big Pharma companies.
Since it all began, the pharmaceutical industry and law firms that represent them have hired at least 46 investigators, attorneys, and supervisors from the DEA, including 32 directly from the division that regulates the drug industry.
Remember that guy Linden Barber, who authored the bill that many say stripped the DEA of the power to go after Big Pharma companies? Well 3 months ago Cardinal Health, that second-largest drug distributor we were talking about that went after Rannazzisi through his boss, hired Linden Barber as the senior vice president!
Other former DEA agents and lawyers have gone on to take up so pretty prestigious positions working for drug companies, or law firms and other organizations working in the pharmaceutical industries best interest.
Joe Rannazzisi now consults with state attorneys general who have filed suit against distributors for their role in the opioid crisis.
Oh… and let us not forget Congressman Marino, who was just nominated to become President Trump’s new drug czar.
Remarkably, there are a lot of instances of people in the DEA being influenced by pharmaceutical companies and lobbyists to stand up for drug companies instead of the tens-of-thousands of Americans dying from opioids each year. In many of these instances, the individual’s go on to get high-earning jobs defending the interests of the Big Pharma industry.
So is it a made-up conspiracy? Or are pharmaceutical companies buying their way out of trouble at every turn and pushing out people like Rannazzisi who stand up to them? Is it really that hard to believe when you connect the dots?
With an ongoing opioid epidemic doing major damage to the country, we have to acknowledge everything that has contributed to this issue. Even if we set aside the idea of placing blame, we cannot prevent it from getting worse or happening again if we don’t acknowledge what helped cause it. Every drug company, policy maker, pharmacy, crooked doctor and individual should be accountable to taking action to make things better. It starts with accepting the issue and building a foundation to recover. If you or someone you love is struggling, please call toll-free now. We want to help.
CALL NOW 1-800-951-6135
While the entire country has been impacted by this ongoing issue, more options for prevention and treatment have become paramount to changing the tides. Just this week Rick Scott, the governor of the state of Florida, proposed a strategy for fighting the opioid epidemic that has gained a lot of attention. Scott has decided to ask local lawmakers to impose a three-day limit on opioid prescriptions during the upcoming legislative session. This latest development is one new piece of recent initiatives to combat the opioid crisis.
Florida Governor Opioid Initiatives
During two press conferences on Tuesday, the Florida Governor announced a pushback on an abundance of opioid prescriptions, while also introducing other ideas for fighting addiction.
One of the initiatives Rick Scott is pushing is to require all health-care professionals who prescribe controlled substances to participate in the Florida Prescription Drug Monitoring Program, also known as the PDMP. This database involves health-care professionals to report important information on patients receiving powerful narcotic medications, including:
- Name of the doctor
- Patient name
- Prescription information after the prescription is filled
But this is not the last of Florida Governor Scott’s opioid initiatives. His office also plans to seek additional reforms such as:
- Fight unlicensed pain management clinics
- Requiring education on responsible opioid prescribing
- Creating more opportunities for federal grants
Scott apparently plans to put some more investments toward helping those already struggling. He is also pushing for more than $50 million for services including:
Part of this initiative is also boosting up the budget of the Florida Violent Crime and Drug Control Council.
At the moment the finer details of the Florida Governor’s proposals are not yet available. However, what it does tell us is that Scott is not ignoring the contribution Big Pharma makes in this current crisis. What we can tell from this outline is that Rick Scott says he is aiming to address prescription opioid pain medication, recognizing it as a key source of the growing problem.
Why 3 Days?
It has been reported time and time again that we should be paying attention to how powerful opioid medications impact rising addiction rates. Now the Centers for Disease Control and Prevention (CDC) has released a recent study showing how quickly someone could get hooked on these kinds of drugs. In this study it is shown:
- After three days of use, about 6% of patients were still using opioids a year later.
- Five days into use, about 10% of patients were still using opioids a year later.
- After 11 days of use, it jumps to 25% of patients still taking opioids a year later.
So it would seem that between 3-5 days, the chances of continued use almost doubled. Then between 5-11 days the chances of use more than doubled. This development may have helped inspire the idea to limit prescriptions to 3 days.
Back in March, Bradley Martin of the CDC, one of the study authors, told Vox magazine:
“There’s nothing magical about five days versus six days, but with each day your risk of dependency increases fairly dramatically,”
So while day 5 and day 6 may not be a dramatic leap over the edge, some may see this proposed limit as an attempt to at least slow a process down.
The Opposing Argument
The Florida Governor will probably face strong criticism, or at least skepticism, from crowds such as:
The opposition is still very real. This isn’t even the first time Florida lawmakers have seen something like this brought to the table. Just last year Florida legislatures quietly rejected an effort last year to impose a five-day cap on opioid prescriptions for acute pain.
Legislatures and doctors are the only concerns Florida Governor may have to tangle with in order to push this idea through. Other potential obstacles standing against this proposal include:
- Additional out-of-pocket co-pays that patients will incur
- The ability of patients with chronic pain and terminal illnesses to refill prescriptions
The Florida Society of Interventional Pain Physicians will discuss caps on prescriptions during a board meeting today. Dr. Sanford Silverman is a past president of the Florida Society of Interventional Pain Physicians. In regards to the 3 day limit he stated:
“We don’t think the cap is reasonable since it is a completely arbitrary number,”
“A better idea would be to mandate usage of the PDMP prior to writing an opioid for acute pain.”
Other states have created caps on prescriptions, although some may not seem as strict as the 3 day rule.
- Massachusetts limits the supply to seven days.
- New Jersey set it so that first-time prescriptions for acute pain cannot exceed a five-day supply. Also, patients being treated for cancer or under hospice care are exempt.
- Ohio caps distinguish between patients with chronic pain and those with acute pain.
At the end of the day, similar strategies may not be left up to the lawmakers. If pharmacies decide to impose their own limits on certain prescription drugs the Florida Governor might not have to push very hard to get the limits he is looking for.
CVS announced Friday that the company plans to:
- Limit the daily dosage of pain pills based on their strength
- Require the use of quick-release painkillers before extended-release opioids are dispensed
- Limit opioid prescriptions to seven days for certain conditions
This restriction will specifically apply to patients who are new to pain therapy.
Only time will tell how far Florida Governor Rick Scott’s new pitch will go, but it seems one thing people can agree on is that the opioid crisis does require some new approaches to prevention.
With more prevention we may be able to slow down the rising rates of opioid addiction. Meanwhile, the need for safe and effective treatment still means a lot for helping those already suffering. Real treatment resources matter. If you or someone you love is struggling, please call toll-free now. We want to help.
CALL NOW 1-800-951-6135