The Palm Beach Post

Scott: Limit opioid doses to 3 days

Governor also asks legislator­s to require medical profession­als to use prescripti­on drug database.

- By Christine Stapleton Palm Beach Post Staff Writer

Gov. Rick Scott will ask lawmakers to impose a three-day limit on opioid prescripti­ons during the upcoming legislativ­e session as part of his initiative to combat the opioid crisis.

Scott’s initiative­s — announced at two news conference­s on Tuesday — also include requiring all health care profession­als who prescribe controlled substances to participat­e in the Florida Prescripti­on Drug Monitoring Program, also known as the PDMP.

The database requires health Read The Post’s investigat­ive coverage of the county’s $1 billion addiction treatment industry at care profession­als to report the name of the doctor, patient and the prescripti­on after the pre-

scription is filled.

Scott will seek additional reforms to fight unlicensed pain management clinics, require education on responsibl­e opioid prescribin­g and create opportunit­ies for federal grants.

Scott also proposed an investment of more than $50 million for substance abuse treatment, counseling and recovery services along with beefing up the budget of the Florida Violent Crime and Drug Control Council.

Details of his proposed legislatio­n were not available. Still, the initiative­s proposed indicate that Scott intends to combat opioid addiction where much of it begins: prescripti­on pain medicine.

A recent study by the Centers for Disease Control and Prevention showed how quickly someone could get hooked on the drugs. After an initial three days of use, about 6 percent of patients were still using opioids a year later.

By day five, it was 10 percent. At an initial 11 days of use, 25 percent of patients were still taking opioids a year later.

“There’s nothing magical about five days versus six days, but with each day your risk of dependency increases fairly dramatical­ly,” Bradley Martin of the CDC, one of the study authors, told Vox in March.

Still, Scott’s intention to limit opioid prescripti­ons to a three-day supply will likely face intense scrutiny from the medical community, insurance and pharmaceut­ical companies and consumer groups. Florida lawmakers quietly rejected an effort last year to impose a five-day cap on opioid prescripti­ons for acute pain.

Among the potential hurdles: Additional out-ofpocket co-pays that patients will incur and the ability of patients with chronic pain and terminal illnesses to refill prescripti­ons.

The Florida Society of Interventi­onal Pain Physicians will discuss caps on prescripti­ons during a board meeting today.

“We don’t think the cap is reasonable since it is a completely arbitrary number,” said Dr. Sanford Silverman, past president of the society. “A better idea would be to mandate usage of the PDMP prior to writing an opioid for acute pain.”

Massachuse­tts, like other states that have imposed caps on prescripti­ons, limits the supply to seven days. However, in New Jersey, firsttime prescripti­ons for acute pain cannot exceed a fiveday supply. Also, patients being treated for cancer or under hospice care are exempt. Ohio’s caps distinguis­h between patients with chronic pain and those with acute pain.

The issue may be taken out of the hands of lawmakers if pharmacies decide to impose their own limits.

CVS announced Friday that it will limit opioid prescripti­ons to seven days for certain conditions. The restrictio­n will apply to patients who are new to pain therapy. CVS will also limit the daily dosage of pain pills based on their strength and will require the use of quick-release painkiller­s before extended-release opioids are dispensed.

Scott made no mention of the Palm Beach County Sober Home Task Force, which was tasked by the Legislatur­e to investigat­ion corruption in sober homes and the drug treatment industry.

During the last legislativ­e session, the task force successful­ly ushered through legislatio­n that targeted marketing scams, increased penalties for patient brokering and gave the Department of Children and Families more authority to regulate the industry.

The task force’s efforts — although aimed at unlawful business practices — also combat the crisis by ending the cycle of relapse created by unscrupulo­us treatment providers who profit when an addict returns to treatment.

Palm Beach County State Attorney Dave Aronberg will discuss the task force’s legislativ­e initiative­s today.

 ?? BRUCE R. BENNETT THE PALM BEACH POST ?? Gov. Rick Scott speaks to members of the media at a news conference at the sheriff’s office in West Palm Beach on Tuesday.
BRUCE R. BENNETT THE PALM BEACH POST Gov. Rick Scott speaks to members of the media at a news conference at the sheriff’s office in West Palm Beach on Tuesday.

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