The main sponsor of a bill that would ban doctors from prescribing more than seven days’ worth of opioids says it’s also time to consider stiffer penalties for doctors who overprescribe the highly addictive painkillers.
“It’s an area of the law we’re going to start looking into,” said state Sen. Gene Yaw. The Williamsport-area Republican said he expects lawmakers to hold a hearing this summer.
Yaw is the prime sponsor of the bill to impose the seven-day limit. The bill passed the Senate last week and could come up for a vote in the House this week. However it contains no criminal or civil penalties for doctors.
The bill would make it a crime for doctors to write a prescription of more than seven days for an opioid painkiller such as Oxycontin or Vicodin. Pennsylvania previously passed laws against opioid prescriptions of more than seven days for minors and for emergency room patients.
As with the law pertaining to minors, the one for adults contains exceptions, such as patients with cancer, terminal illness or patients who have had major surgery.
However, doctors would be required to document the reasons for the longer prescription. Also, doctors would have to talk to the patient about matters including correct use of opioids and risk of addiction.
Pennsylvania has already issued guidelines to prevent doctors from overprescribing opioids, which can be highly addictive. Pennsylvania’s biggest insurers have also greatly reduced the duration of prescriptions they will pay for.
The guidelines are intended to cut into long term use that can lead to dependence and addiction, or result in unfinished supplies that can fall into the hands of young people or others who might abuse the pills and become addicted.
The U.S. Centers for Disease Control and Prevention has also weighed in heavily, stressing to doctors that opioids are intended for severe short-term pain, and long-term use can result in dependence and increased tolerance and risk of overdose, respiratory failure and death. The CDC has further advised doctors to prefer other forms of treatment, such as non-opioid painkillers and physical therapy, for long-term pain.
The crackdown on opioid prescriptions has caused chronic pain patients to complain they are being denied long-term medications they legitimately need in order to function and be pain-free, and are suffering as a result.
Even the CDC guidelines, they say, have a chilling effect on doctors, causing doctors to drop and avoid chronic pain patients. They further argue such guidelines and laws come between doctors and patients, preventing doctors from making the appropriate medical decisions based on individual patients’ situations.
In 2017, 47,600 deaths in the United States were blamed on opioids, up from 8,048 in 1999, according to the federal government. However, pain sufferers and their advocates stress the majority, about 30,000, involved illegal opioids such as heroin or illegally-obtained prescription opioids
Yaw said his bill allows doctors to treat the individual needs of patients and isn’t designed to prevent people who legitimately need longer prescriptions from getting them. One benefit of the law, he said, might be to give more weight to doctors trying to convince patients long-term opioid use isn’t their best option.
“If that works and cuts down on people using it unnecessarily, so be it,” he said.
Yaw said the limit is a needed response to the opioid addiction and overdose crisis state officials say is responsible for 15 deaths per day in Pennsylvania.
Regarding criminal penalties for doctors, Yaw said he hasn’t decided whether it’s needed. “There may be many reasons against it. I think it’s worth looking into,” he said.
Some doctors around the U.S. have been prosecuted over opioids. But those cases tend to involve federal laws pertaining to things such as fraudulent prescriptions or trading prescriptions for money or sex.
