Chris Christie wants to limit painkiller prescriptions. Will that cut back on opioid addiction?
New Jersey Gov. Chris Christie has called for emergency curbs on the prescription of opioids, a move that would mirror laws in several other states that have curtailed the length of first-time prescriptions.
http://www.csmonitor.com/USA/2017/0111/Chris-Christie-wants-to-limit-painkiller-prescriptions.-Will-that-cut-back-on-opioid-addiction
ONCE AGAIN… politicians use EMERGENCY RULE MAKING to AVOID a public comment period. Since we have 45 million alcoholics and 35 million addicted to Nicotine and > 550,000 death associated with the use/abuse of those drugs… Maybe more deaths could be prevented if we limited Alcohol sales to ONE OUNCE SINGLES of liquor and single can of beer – like is found on airplanes and cigarettes be sold as “singles” and there has to be a national registry that would limit the number could be purchased in a single day or days in a row.
Gov Christie had to have “lap-ban” surgery in May 2013 to help him “deal” with is “addiction to calories” and if the above picture is recent… while it appears to have lost weight, but a recommended weight loss is ONE POUND PER WEEK.. it has been nearly 200 weeks since his surgery… 200 lbs lost ?
—Gov. Chris Christie wants to tackle New Jersey’s opioid epidemic with an emergency measure that would place the state between doctors’ prescription pads and their patients.
Speaking at the State of the State address Tuesday evening, Mr. Christie called on New Jersey Attorney General Christopher Porrino to “use emergency rule-making and other regulatory reform to limit the supply of opioid-based pain medications,” hoping that a reduction in initial prescription length from the current 30-day supply limit to just five could prevent some patients from becoming addicted to the pills.
New Jersey isn’t the first state to propose drastic steps in response to the nationwide opioid crisis. States such as Massachusetts, Connecticut, New York, and several others have passed similar laws, arguing that the action could reverse the upwards trend of opioid-related deaths, which jumped to a record of 33,000 in 2015, according to the Centers for Disease Control and Prevention (CDC). But pharmaceutical companies and doctors object. Some note that opioid prescriptions have declined 12 percent since 2012, as The New York Times reported. And they maintain that prescription lengths should be a conversation that takes place between doctors and patients without the government’s input, and worry that the interference could discourage doctors from prescribing opioids at all.
“When you see a state legislature or governor or attorney general put forward this type of intervention, what it demonstrates is an understanding of what’s been fueling the opioid crisis,” Andrew Kolodny, the director of the Opioid Policy Research Collaborative at Brandeis University’s Heller School, tells The Christian Science Monitor in a phone interview. “Until very recently, which is why I think the epidemic has worsened … policymakers didn’t understand that over prescribing was fueling the problem.”
For years, opioids were viewed through two distinct lenses: heroin, a dangerous and illicit substance used by drug abusers, and painkillers, medications given to relieve the pain of those who were injured or underwent a surgical procedure, or suffered from chronic pain. Pharmaceutical companies spent the past two decades urging doctors to issue looser, lengthier prescriptions, using targeted marketing campaigns to dismiss fears that the pills could lead to serious addictions and normalizing drugs that were previously doled out sparingly in extreme cases.
But as the number of overdoses and fatalities associated with the drugs rose, more began to see that many of the people who lost their lives in the ongoing epidemic began using prescription drugs for a minor injury and quickly became addicted to the highly potent pills, a revelation that changed the face of addiction.
Mr. Porrino said Wednesday he planned to submit Christie’s recommended rules to state regulators by the end of the month. The rules could be put into place within 30 days under the emergency law statutes.
“This allows us to take action very quickly,” Porrino told NJ.com.
Additionally, on Tuesday, Christie called on Porrino to open “an investigation of the prescribing practices of our medical community and their interaction with the industry manufacturing these drugs,” a move that mirrors investigations in New Hampshire and Chicago that resulted in lawsuits against opioid manufacturers.
The prescription limit won’t have an effect on those who are introduced to the drugs through heroin, and likely will play little role to keep those addicted to pain pills from overdosing, Dr. Kolodny says, noting that such measures aren’t a cure-all for the crisis. But the rules could limit the number of new patients that go down the road to addiction, as well as others in their homes who could get hold of the leftover pills.
Experts are scrambling to find solutions to the epidemic, but some doctors maintain that blanketed limits undermine the authority and expertise of medical professionals.
“Arbitrary pill limits or dosage limits are not the way to go,” Patrice Harris, chairwoman of the American Medical Association’s committee on opioid abuse, told Pew Charitable Trusts last year. “They are one-size-fits-all, blunt approaches.”
A five-day limit, while slightly stricter than the seven-day limits found in several other states, sounds reasonable, Jonathan Chen, an instructor at Stanford University School of Medicine who has researched opioid abuse, says. Including a provision that allowed patients who did not receive adequate dosages to return to their doctors for additional pills would be key. And while that may be an inconvenience for some patients and busy doctors, it could cut back on the excess of pills lying around.
He also said drug-monitoring databases, which allow doctors to see what prescriptions patients have received from other physicians in the state, can help doctors to catch abusers who frequent multiple clinics.
“There’s no conflict between improving the quality of care for those with pain and reducing opioid use. What’s been set up is a false dichotomy: one of the pushes of the pharm lobby is to argue that any effort to rein in runaway prescribing is going to cause suffering and deprive people of necessary pain treatments,” Dr. Alexander said.
Still, Dr. Chen says, there’s also a societal shift that needs to happen alongside the law, changing how patients and doctors view painkillers and prompting them to use and prescribe them less.
Others point to medical marijuana as a possible, less-addictive substitute. In states where the substance has been approved widely for medical use, the number of deaths related to opioid abuse fell by 25 percent.
Government intervention in the medical sphere remains largely unwelcome by doctors and patients, who often feel their levels of expertise and private, personal cases may not fit neatly into legislation. Still, others aren’t sure how to reverse years of overprescribing that have come to define modern pain medicine, and think legal action could be the most effective solution.
“I don’t know if I want [the government] to be the one doing it, but they’re kind of in the position to be doing it,” Chen says.
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