Page 20 - Volume 70 Number 2
P. 20

OTHER STATES’ RESPONSES
TO THE OPIOID CRISIS
By Richard E. Burney, MD
Here is what is happening across the country regarding opioid prescribing. Michigan’s new laws are not so different than other states’.
New laws or proposed laws generally address prescribing, education, detection and treatment of Substance Abuse Disorder (SUD), harm reduction (drug takebacks, naloxone, needle exchange.)
■ OHIO
● 7-day Rx limit adults, 5-days limit minors.
Prescribers who violate can lose license
■ NEW JERSEY
● No refusal of SUD treatment
● Requires insurance coverage minimum 180 days,
no waiting period
● Pre-payment requirement by providers banned ● Atty general will monitor for waste, fraud and
abuse
■ RHODE ISLAND (not impressive) ● Law enforcement PDMP access ● Discuss risks of addiction
● Permits e-prescribing
■ OREGON (not impressive)
● Prescribe lowest dose
● Urine test or stop prescribing if suspicious about
diversion
● Avoid co-prescribing opioids and benzos
■ NEW MEXICO
● Requires use of PDMP ● Naloxone access
■ NEW HAMPSHIRE (required practices, there is also a state practice guideline)
● History & physical examination
● PDMP
● Use and document opioid risk screen tool ● Controlled med agreement
● Acute treatment seven days or less only
● Availability 24/7 for opioid treated patients
■ NEW YORK
● Requires 3 hours CME by July 2017
● Encourages PDMP use
● Expand use of naloxone
● Various generalities about stigma, etc.
■ GEORGIA
● Naloxone available to all
● Addiction treatment center regulations ● Check PDMP (non-specific)
■ ALASKA
● Disaster declaration – naloxone distribution
● Patients can refuse opioids in care???
● Requires prescriber CME
● Seven-day Rx limit
● Look for pet owner abuse of veterinary medications
■ MARYLAND
● Opioid command center
● Seven-day Rx limit
● Illegal sales resulting in death = felony up to 30
years jail
● Naloxone “easier filling Rx”
● Increased funding for addiction treatment
■ INDIANA
● Increased treatment
● Pilot to pay for OB/GYN to be trained in
buprenorphine
● Pilot detection of neonatal abstinence syndrome ● Create treatment for homeless addicts
● Mobile treatment teams – detox, med assisted
treatment, counseling, but not funded
■ SOUTH CAROLINA
● Instruction of high school students on drug abuse ● Good Samaritan law
● Prescribers must be trained in and use the PDMP ● Report fetal substance exposure
■ KENTUCKY
● 3-day acute pain opioid Rx limit (exceptions for
cancer, end-of-life, but that is not “acute”)
● Pending: OTC naloxone, more addiction treatment beds, neonatal abstinence program, move to scrap
pain as “5th vital sign”
■ CONNECTICUT
● 7-day limit, 5-day limit for minors
● Must discuss risks of taking opioids with alcohol,
other specific meds
● Require electronic prescriptions?
■ MASSACHUSETTS
● New Rx 7-day limit has loopholes like “pain related
to an acute medical condition”
● Discussion about risks
● Controlled substance agreement for chronically
treated patients
● Prescribers must have CME on pain/opioids
● Prescribers must check the PDMP (before writing
a CII or CIII Rx)
20 Washtenaw County Medical Society BULLETIN
APRIL / MAY / JUNE 2018


















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