February 5, 2018

State Legislatures Increase Action Against Opioid Epidemic

Following a unanimous passage from the House and Senate, Arizona Governor Doug Ducey recently signed the Arizona Opioid Epidemic Act, which limits initial opioid prescriptions to five days for all opioid naïve patients, while also limiting the dosage to levels defined in federal prescribing guidelines.

The bill also expands access to naloxone, enacts Good Samaritan laws for opioid overdoses, enhances continuing medical education for opioid prescribers, and requires pharmacists to check prescription drug monitoring programs (PDMPs) prior to dispensing opioids.

This sweeping resolution is a multi-pronged approach to curbing the opioid epidemic, and is just one of many recent state-driven initiatives across the country.

Tennessee Governor Bill Haslam announced a comprehensive plan that established five-day, 40 MME (morphine milligram equivalent) limits for initial opioid prescriptions, while also establishing a special opioid commission and investing $25 million for treatment and recovery services for opioid dependent individuals.

Meanwhile, North Carolina proposed new opioid prescribing guidelines to limit opioid use to 12 weeks or less for acute pain, with five-day, 50 MME dosing limits for initial prescriptions, and Pennsylvania declared the heroin and opioid epidemic a statewide disaster, implementing 13 key initiatives, including expansion of the state PDMP, increasing access to naloxone, and improving access to medication-assisted therapy.

Healthesystems has previously explored how state and federal legislatures have attempted to bridge the gap between opioid policy and prescribing, but it appears that states are now leading that charge more than ever, as 2018 has already seen a plethora of opioid laws enacted.

Earlier this year, Michigan passed opioid prescription limitsNevada implemented prescription limits passed last year, South Carolina created an Opioid Emergency Response Team and plans to create an opioid prescribing policy, and California recently held a hearing to discuss ways to use their PDMP to better track opioid prescriptions.

With so much momentum behind state-driven opioid legislation, it is likely that more laws will continue to pass in upcoming years. Since January 1st, there have been over 113 new pieces of legislation introduced which address opioids, and of those 43 would directly impact workers' compensation if passed into law. The collective efforts of these initiatives, if passed, will undoubtedly play a role in lessening the impact of this devastating epidemic.

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