Source: NJ Spotlight
Gov. Chris Christie framed his pledge to limit opioid prescriptions to a five-day supply, one of several new concepts he outlined in his State of the State speech Tuesday, as a way to curb the availability of these highly addictive medications and help “prevent addiction before it starts.”
But advocates for those prescribing these pills are adamant that the change would do more harm than good. Limiting prescriptions could endanger patients with legitimate pain and possibly drive them to harder drugs, like heroin, they said. Such mandates could also discourage doctors from becoming licensed to prescribe such drugs, further limiting the options for desperate patients.
“We need to be very careful about how all this attention to the overuse of opioids has stigmatized the cancer patient … has stigmatized all patients with pain,” said Dr. Kathleen Foley of Memorial Sloan Kettering Cancer Care at a conference on pain and addiction held at the Princeton University Center for Health and Wellbeing, in December.
The issue is one of several Christie outlined in his annual speech that are likely to generate political heat and policy debate; his call for an insurance mandate requiring coverage for six months of residential or outpatient drug treatment has also sparked spirited discussion among industry leaders, regulators, and other stakeholders. The governor also proposed plans to open up new treatment beds, especially for older teens, and expand access to sober housing and job opportunities.
For those who are dependent, a life without medication can mean pain — and potential physical withdrawal. And some fear that, if they don’t have pills, the overpowering need for relief will drive these desperate patients to seek out street drugs like heroin to get some immediate relief.
Advocates for physicians point to data from the federal Centers for Disease Control and Prevention, released in December, that shows heroin-related deaths shot up more than three-fold between 2010 and 2014, suggesting it reflects in part the impact of regulations designed to limit access to prescription opioids.
Another concern is the long-term impact of these mandates on physicians and their interest in prescribing opiates and other pain medications, Azam said. In New Jersey, this requires a separate license — and another set of fees — in addition to their standard medical license.
She pointed to data compiled for a Boston Globe article published earlier this month that suggested more than half of doctors nationwide are curtailing their opiate prescription practice and one in ten are getting out of the business. More than one-third of the 3,000 physicians who were surveyed said these changes have hurt patients with pain.
While the overall goal the governor outlined in the speech — reducing the impact of addiction — was generally well received, observers have started to question how some of the specifics will be implemented and, in some cases, if they are overly broad.