Better Control of Opioids - Sort Of

By Amy Jeanroy

The recent compromise on a bill created to reduce the length of prescriptions and dosage of opioids is part of the ongoing crisis in Maine. The rampant epidemic that seems to be growing out of control, I daresay, IS out of control, and it’s not going to go away with a gentle nudge. 

“We know of no other medication routinely used for a nonfatal condition that kills patients so frequently,” CDC Director Tom Frieden and Debra Houry, director of the agency's National Center for Injury Prevention and Control, wrote in the New England Journal of Medicine.

After reading that the LePage administration agreed to lengthen the time for prescriptions to seven days for acute pain and 30 for chronic pain, because in part, rural residents have to travel long distances to pick up their prescriptions, is to me, a loophole that takes the teeth out of the bill. We in Maine, have to stop looking for excuses for why we can’t make hard decisions and instead prove that we are serious about controlling the drug epidemic in our state.  

The bill, if approved, would go into law in 2017, giving current patients a chance to taper down to the less than the daily 100 morphine milligram limit. We all know how often that works out. Hoping a drug addict stops using drugs certainly doesn’t save many of them. I’m not sure how that is helping the overall crisis we find ourselves in. 

It would be interesting to see if there are any repercussions for doctors who are prescribing opioids as often as they are. What does “medically necessary” actually mean? Asking a doctor if they only prescribe opioids to patients when it is medically necessary seems to be a leading question, doesn’t it? 

Prescribing an addictive substance to a high school student for a pulled muscle is the real crime here. Perhaps some retraining in the use of Tylenol or Advil might help hundreds of young Mainers not to get on the opioid train to begin with. 

Unfortunately, the big stopping block in the new regulation would be waiting for the insurance company to give prior authorization before reimbursing for additional prescriptions. There is also hope with the prescription monitoring program. According to an article in the Portland Press Herald, it would make Maine one of the strictest states in the country for prescribing practices.

Look, I don’t need a lesson about the complexity of addiction. My youngest brother Colin committed suicide after years of drug abuse. He was an addict of the highest order. My parents were completely in denial about the situation, and were spectacularly adept at making excuses for him. It was a very dark time in our family’s history. I can’t help but wonder if a real law, an actual law that put very strict controls on this very dangerous and addictive substance would have helped him. I will never know, but what I do know is this: controlling the number of new addicts is just as important as getting help for the old ones. 

Better than nothing? Of course it is. Good enough? Time will tell. 

 

(What do you think? Email editorcalais@gmail.com with your comments.)