Opioids. Opiates. Prescription painkillers. Heavy narcotics.

All of these are names that can refer to the prescription medicines that resemble opiates in their pharmacological effects. They may include drugs containing morphine, codeine, oxycodone, or hydrocodone. With proper use, these prescriptions can be a safe way to manage pain and create a greater quality of life. Unfortunately, their effects can also lead to tolerance, addiction, and overdose. According to the Trust for America’s Health, overdose deaths from prescription drugs have doubled in 29 states since 1999. Of these states, deaths have tripled in another ten and quadrupled in four. In Nevada, drug overdose deaths have increased 80% since 1999.

Many states are beginning to seriously combat this problem, with many states introducing opioid regulations to control the wide-spread misuse and abuse.

Most states have now implemented prescription drug monitoring programs that track prescription drug use by individuals in a shared database for use by medical professionals. This can curb some of the “doctor shopping” that occurs when patients go to multiple doctors in order to secure multiple prescriptions.

In a state by state comparison of regulations aimed at curbing opioid abuse, states like New Mexico and Vermont scored highest at implementing opioid regulations. Nevada scored medium-high (a seven on a scale of one to ten, with ten being the best), instituting effective programs on par with states like Florida and Tennessee. The lowest ranking states (scoring only a two or three) were Missouri, Nebraska, and South Dakota.

Some examples of state-wide legislation include Alabama’s introduction in August of 2013 of a trio of bills that gives medical personnel better access to the state’s program for monitoring prescriptions, tightens the regulations on pain management clinics, and actually makes “doctor shopping” a Class A misdemeanor. Other states, like Indiana and Kentucky, are also tightening regulations on pain management clinics. In Washington state, doctors now have to get a second opinion from a pain specialist for any prescriptions over a certain dosage.

In Nevada, prescribers are required to use the prescription drug monitoring program, patients must have a physical examination before receiving a prescription for a controlled substance, and individuals that are suspected of misusing opioids can only use a single prescriber and pharmacy. Further, Nevada has introduced programs to expand coverage of substance abuse services and treatment.

Other recommendations from the Trust for America’s Health report include instituting a drug take back program, like Clark County’s Pain in the Drain program, as well as more rigorous prescription drug monitoring programs. 

These regulations, however, are not meant to hamper access of these drugs to those chronic pain patients that do need them. They are meant to make sure that patients can safely and effectively access these drugs from trusted and responsible healthcare providers.

What are your thoughts on opioid regulations? 

Image by Good Eye Might via Flickr



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