Scott to ask lawmakers for 3-day cap on opioid prescriptions

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

Scott’s initiatives — announced at two press 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-care professionals to report the name of the doctor, patient and the prescription after the prescription 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-of-pocket 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, first-time prescriptions for acute pain cannot exceed a five-day 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 at a meeting of the Palm Beach County Legislative Delegation today.

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