House OKs limits on opioid prescriptions

Physician groups have had concerns with prescription limits.

Rep Julio Gonzalez, R-Venice, and an orthopedic surgeon, warned Thursday that the limitations would be too restrictive for some patients and that 10 days may be more appropriate for people who have had major surgery or suffered major trauma.

But Boyd told the stories of two people he knows who underwent surgery. One person had complete knee reconstruction and walked out of the facility with a walker hours later. He had a follow-up four days later.

Another friend of his was treated for a heart-valve replacement and an aneurysm repair. Boyd said his friend took Tylenol for three days in the interim between being released and a followup visit.

In both instances, he said, the men were given 90-day prescriptions for opioids to relieve the pain.

“We are not trying to be doctors,” Boyd said, addressing Gonzalez’s criticism. “We are not trying to tell doctors how to do what they do, because they are the professionals. But I think there’s a little bit of work that needs to be done communicating, that with this horrible problem, we need to take dramatic steps to try to fix it.”

Opioid addiction and overdoses are now the leading causes of accidental death in the U.S. According to research, 80 percent of heroin users first abused prescription drugs, whether their own drugs or someone else’s. Other studies show that a patient’s chances of addiction increase as the number of days for a first prescription for opioids lengthens.

The data have spurred state lawmakers to focus not only on treating drug users but on trying to keep patients from getting hooked in the first place.

To ensure that patients aren’t “doctor shopping,” or seeking prescriptions for addictive drugs from multiple physicians, the bill also would require physicians to consult a statewide database before prescribing or dispensing controlled substances, something many physicians have been loath to do.

Only about 27 percent of Florida health care providers authorized to prescribe controlled substances use the database, known as the prescription drug monitoring program.

The bill includes accommodations if the database is down or if there are electrical or technical issues. But in such instances, physicians would be required to docu- ment information in patient medical records and would be limited to prescribing three-day supplies or less of pain relievers.

The bill also would authorize the Department of Health to share and exchange database information with other states and would authorize the database to interface with electronic health systems used by health-care practitioners and facilities.

Lawmakers have set aside about $1 million for improvements to the prescription drug monitoring program, but Rep. Gayle Harrell, RStuart, worried that the funding may not be enough to ensure that the database properly interfaces with electronic health systems used by physicians.

Harrell, who is married to a physician, said she shared Gonzalez’s concerns that the restrictions may go too far.

“I think the 10 days seems much more reasonable,” she said.

Boyd, who will leave the House this fall because of term limits, said he knows the opioid abuse problem will remain.

“I’ll be gone next year, but I hope that others of you will take up the fight and take the next steps to fight this problem because I don’t think it’s going to completely go away,” he said.