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7-Day Limit On Pain-Killer Prescriptions Part of Sweeping Proposal To Crack Down on Opioids

| October 15, 2017

Freebasing. (Churl Han)

Freebasing. (Churl Han)

Doctors would be limited to prescribing seven days’ worth of opioids for patients with acute pain and would have to check a statewide database before ordering most prescription pain medications, under a proposal filed Friday in the state House.

The 114-page bill, sponsored by House Commerce Chairman Jim Boyd, R-Bradenton, incorporates proposals put forward by Gov. Rick Scott aimed at curbing the opioid epidemic that has engulfed the state.

Scott’s office issued a news release Friday announcing the filing of the measure, an indication of the importance of what will be one of the most-pressing issues for the Legislature during the session that begins in January.

“Families across our state are struggling with pain and loss inflicted by the national opioid epidemic and today I am proud that Senator Benacquisto and Representative Boyd are filing important legislation to help combat this terrible crisis,” Scott said in the release. Senate Rules Chairwoman Lizbeth Benacquisto, R-Fort Myers, is expected to file a companion measure to Boyd’s bill.

The proposal (HB 21) would limit doctors to writing prescriptions for three days’ worth of opioids, such as highly addictive oxycodone, unless the practitioner decides a seven-day prescription is “medically necessary to treat the patient’s pain as an acute medical condition.”

For the week-long supply, physicians would have to document the patient’s “acute medical condition and lack of alternative treatment options to justify deviation” from the three-day limit.

Some doctors, especially those who work in emergency rooms, have balked at a three-day limit and the requirement for documentation, which they say would take away time from patients.

Critics of a three-day limit also say that prescription-drug restrictions, while possibly stopping new patients from becoming addicted, won’t do anything to address the growing number of overdoses on heroin and fentanyl, a deadly synthetic opioid often mixed with heroin.

“In the emergency department, we see four to five overdoses a day,” Aaron Wohl, an emergency doctor in Lee County, told the Senate Health Policy Committee this week. “They’re not any using (prescription) medications. They’re using fentanyl and heroin.”

The limits are grounded in research that shows patients who took powerful pain medications for the first time had a higher chance of developing dependencies with longer prescriptions.

For example, new patients with a three-day prescription have a 3 percent chance of becoming addicted, compared to patients with a 30-day prescription, who have a 30 percent chance.

But Scott and his administration have indicated that the governor is open to increasing the three-day limit.

“The goal is to have a conversation and get everybody involved so as we go through this legislative session we have a bill that passes that is going to work to deal with the crisis,” Scott told doctors at a Florida Medical Association opioid summit in Tampa last week, after speaking about the prescription restrictions.

Shortly after Scott spoke, John Bryant, assistant secretary for substance abuse and mental health at the Department of Children and Families, expanded on the governor’s comments, saying Scott was offering an opportunity for doctors to “get it in a way that you think is something less than harsh.”

“We had this discussion in our shop and find that there are a lot of reasons … why three days may be more of a constraint than an aid at this point,” Bryant said.

The bill also includes a controversial component that would require doctors to look up patients on a prescription drug database, called the prescription drug monitoring program. The program has been aimed at keeping patients from getting multiple prescriptions for pain medications from different doctors.

Scott’s push to expand the use of the program is a dramatic departure from where he stood when he took office in 2011.

Then, the governor called for a repeal of the database, known as the PDMP. He reversed his opposition to it as Attorney General Pam Bondi lobbied heavily for the program to curb prescription-drug abuse.

State law now requires pharmacists to check the database before they fill prescriptions for controlled substances, but doctors are not required to consult it.

Many doctors and other health-care providers complain that the system is slow, difficult to use and takes too much time.

Even the state’s surgeon general admitted the database needs work.

“I have heard from many users that our current system is not that user-friendly,” Surgeon General Celeste Philip, who serves as secretary of the Florida Department of Health, told the doctors at last week’s meeting.

Philip said the department is working on updating the system and the revamped program “will be a lot less work.”

Law enforcement officials such as Bondi and some treatment providers view the PDMP as a critical tool.

Mary Lynn Ulrey, a nurse practitioner and CEO of Tampa-based Drug Abuse Comprehensive Coordinating Office, called the plan released Friday “the beginning of the beginning.”

“I do think the problem is on multi-levels. If people can’t get prescription drugs for pain management, they will turn to other drugs, like heroin. So it’s a start,” Ulrey told The News Service of Florida in a telephone interview. “I am glad to see discussion around the bill. I’m hopeful that they’re paying attention. They know it’s a crisis. And they’re trying to do something.”

The proposal would also require pharmacists to check photo identification of patients before handing over controlled substances. A Senate panel heard complaints this week about patients who use aliases as a way of avoiding being tracked in the PDMP.

The bill drew praise from Walton County Sheriff Michael Adkinson, the president of the Florida Sheriffs Association, who noted that Senate President Joe Negron, R-Stuart, and House Speaker Richard Corcoran, R-Land O’ Lakes, were also quoted in Scott’s news release Friday.

“I think that tells you that they understand what we’re all dealing with here. It’s that serious,” he said.

–Dara Kam, News Service of Florida

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15 Responses for “7-Day Limit On Pain-Killer Prescriptions Part of Sweeping Proposal To Crack Down on Opioids”

  1. Linda L says:

    So, in other words, I can now add to the price of my prescription for one of my pain killers’, another $30 co-pay for each visit to get a written prescription (= an additional $120) plus for those of us who do not have transportation, nor drive, an additional cost for a taxi (= at least $25 – $50 or more). My prescription will now cost me, roughly, $170 – $200. And that is only one of my 31 medications. Who are you not trusting – the doctor, the pharmacy, the specialist, or myself? I know my doctor, my pharmacist and my specialist – I do not know you. You did not test me, you have not seen me. Something is very wrong with this.

  2. Born and Raised Here says:

    So the President watches the Opioid addiction on 60 minutes, and now it becomes a concern,

  3. Steven says:


  4. Paul Pasternak says:

    Great plan. Having to go to the doctor once a week to get a new prescription is great for someone who is in chronic pain that is sufficient enough to warrant these meds. On top of that, there goes the cost of healthcare with weekly visits, plus the loss of income from having to take time off from work, that is if you can find a job where you can take off half a day a week. The statewide database for tracking should be a national database.That’s the only part of the law that makes any sense and it doesn’t go far enough. Also, let’s stop lumping all opioids together. Oxycodone is regulated by the FDA. Heroin is not.

  5. Kenneth says:

    While I’m all for control of opioids this control should be more about incoming opioids from other countries along with fentanyl and heroin. Controling doctors who prescribe need medications should be left up to the doctors. For state legislators to take control of medication control that doctors know how to prescribe is just plain stupid. The USA has been trying to control drugs for centuries and have not been able to figure that out or control it to any real effect. How do you even think your local legislators will even be able to figure it out and tell the citizens of the state that they now will have to live with pain for the rest of their lives because they know what is best for you. A restriction of seven days is just plain stupid. Monthly would be more realistic. Also this will create more prescriptions and cost to people who can’t afford the extra time and effort.

  6. Bc. says:

    This only hurts the people who need them it will do nothing for the junkies who wants to get high they will find heroine on the streets. This will make the cartels richer incress crime wile hurting the people who live in pain every day. To go get a new prescription every week the co pays at the doctors and the drug store would be unfair to the people who need them. So the law makers are saying to stop the drug addiction by the junkies
    We will hurt the rest of the people who need them China & Mexico will just send over more fentayl and herion to pick up the slack while the sick suffer. If one wants to do drugs and kill them self they will find a way. Again this will not work it will only increase black makert street Drugs

  7. Proud American says:

    You people are something… no one needs to be on pain medication non-stop… it just makes things worse… my sister went through this crap, doctors would just prescribe her months supplies of pain killers, now her condition is worse over the years and she is going through awful withdrawals… her brain is fried, she is like a zombie… bunch of junkies complaining…

  8. Bc. says:

    Proud American you have no idea what your talking about the people who need them don’t take 3-4 at a time to get high and then need more to get the same high my wife has had 16 surgeries and is in pain every day with pain meds she is Able to get out and have some quality of life so before you lump everyone who suffers every day with pain into you sisters experiences. I can only assume that she did not need to be on them that long the people who need them never over use them or get addicted to them

  9. Buylocal says:

    The medical industry and the government created this situation, and now people in need of pain relief will pay the price of this corruption.

  10. Susan says:

    e-mail the governor ! Tell him what you think and to spend his time doing constructive things – We need sidewalks and street lights to keep kids safe.

  11. Kevin says:

    Proud American is using an anecdotal experience of his sister to justify a dumb knee-jerk government feel good policy which will only hurt those who need these legitimate medicines. How well does he know his sister and the facts behind her abuse. I bet Proud American also argues that guns don’t kill people so apply the same logic here and realize that just because your sister was irresponsible should not be the basis to punish all legitimate patients who need these medicines for chronic pain relief. If you don’t want your arsenal taken away because of morons who abuse guns don’t take away legitimate already well regulated legal prescription MEDICINE from law abiding citizens who need it for their quality of life. We are not junkies.

  12. Proud American says:

    Bc you said people that need them never overuse them or get addicted to them… are you people ok? Opioid? Never overuse or get addicted? I am sorry I got nothing nice to say to your reply…

  13. Bc. says:

    Proud American, yes people who really need them the people who live in pain every day not the drug seekers who munipulate the system to get them to get high DO NOT over use them they get a certain amount each month and they take them the way they are prescribed they do not party with them and I am sure your sisters bad experience have left you with a bad experience with the pain drugs but people are out their taking the drugs responsible it’s not fair that you lump all people who need the drugs to have a little better quality of life with a little less pain into your sisters category and yes it’s true if you don’t abuse them or get high with them you will NOT become addicted dispite what you think millions of people use them with no problem I am sorry your sister got out of hand with them and now you think all people who need pain relief will turn out like her I wish her the best of luck with her recovery

  14. Sherry says:

    Meanwhile BIG PHARMA is BRIBING doctors. . . hundreds of thousands. . . to prescribe their drugs. . . this is just the tip of the iceberg. . . take a careful read:

  15. GWOT Veteran says:

    This bill seems to focus only on those who abuse the drugs while forgetting those who genuinely need long term pain management, if you are unable to work due to a chronic illness which would require you to be on opiates you likely don’t have the money to pay hundreds of dollars for doctors visit every 3 or 7 days, it may at some point be cheaper for those people who actually need it to buy their medicine from a drug dealer.
    Maybe people should consider growing pot and avoid this mess entirely.

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