Opioid Prescription Limits are Facing Challenges

America is battling an opioid crisis, and the Trump administration has joined Congress and state capitals in the fight. But there are a growing number of obstacles now facing patients with legitimate needs for opioids. Patient groups and health providers are increasingly challenging the limits placed on prescription opioids in the name of combating the epidemic.

About 115 Americans die each day from opioid overdose, according to the Centers for Disease Control and Prevention, prompting almost 30 states to pass laws governing how long patients can get opioids or how strong a daily dose can be. Some require long-term users to submit to pill counts or urine tests that often aren’t covered by insurance. In the private sector, liability worries have some pharmacies refusing to stock opioids altogether, while some insurers and drug-benefit managers have said they would limit the doses.

There could be more limits to come. President Donald Trump in March pledged to reduce opioid prescriptions by a third over the next three years. Congress is weighing legislation that would limit first-time opioid prescriptions to three days. More advocacy and doctors’ groups say the measures, while often harming legitimate patients, do little to curtail an epidemic increasingly fueled by illicit rather than prescribed opioids. For example, some evidence suggests constraints on prescriptions are driving opioid misusers to illegal fentanyl, a drug whose use is more likely to result in death, according to a review of government data published in the Journal of American Physicians and Surgeons.

“The decision should be between the doctor and the patient,” said Dr. Patrice Harris, past chair of the American Medical Association. “What the AMA and physicians are seeing is that the policies on restricting opioids are having a negative effect.” Lawmakers and addiction specialists, however, say that the limits are needed because opioids are extremely addictive, and that overprescribing helped fuel the current crisis. Studies have shown there are often more effective opioid alternatives to manage chronic pain, they say.

Millions of patients today are addicted, even though research shows the opioids don’t work for such conditions as fibromyalgia, back pain and headache, said Andrew Kolodny, co-director of Opioid Policy Research at Brandeis University. These patients can be challenging because they don’t want to transition off opioids, doctors say. “Many of them may truly believe the opioids are helping them,” Dr. Kolodny said.

Reference: https://www.wsj.com/articles/opioid-crackdown-has-patients-struggling-to-get-their-meds-1524744001