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States seek to clamp down on opioid abuse

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States seek to clamp down on opioid abuse

A New York law limiting new opioid prescriptions to just seven days expands states’ efforts to prevent overprescribing, but a more comprehensive approach is seen as the best way to limit usage of the potentially addictive drugs.

New York Gov. Andrew M. Cuomo has signed S.B. 8139 that allows first-time opioid prescriptions to include only enough pills for seven days, a reduction from 30 days. Refills are allowed only with further consultation with the prescribing physician or clinician.

“The passing of this bill in New York is a long overdue and certainly appropriate measure and follows what has happened in Massachusetts, Maine and Connecticut,” said Joe Paduda, Skaneateles, New York-based president of CompPharma L.L.C., a workers comp pharmacy benefit management consortium.

The New York law, signed into law in late June and effective July 22, is similar to one in Massachusetts that went into effect in June and also limits first-time opioid prescriptions to seven days. Following the March vote in Massachusetts, Maine and Connecticut also passed similar seven-day limits. Connecticut’s went into effect July 1 while Maine’s goes into effect in January 2017.

Still, some sources say more states need to adopt similar restrictions to substantially affect opioid overprescribing, addiction and overdoses.

Alison Cooper, Albany, New York-based vice president of Northeast state affairs at the American Insurance Association, said Rhode Island and Vermont also passed opioid dispensing legislation, but the bills do not impose a seven-day limit.

“We have seen legislation pass this year in seven states in the Northeast that includes prescribing limitations, strengthening the prescription drug monitoring programs and provider training education,” Ms. Cooper said.

Mark Johnston, St. Louis-based Midwest state affairs director at the National Association of Mutual Insurance Cos., said most states have a prescription drug monitoring program in which patients’ narcotics prescriptions are entered in the system’s database.

That approach helps prevent patients from going to “an emergency room trying to get another prescription,” he said.

However, Mr. Johnson said the monitoring programs’ effectiveness is limited because some states do not require prescribers to check the databases before dispensing medications.

The Pew Charitable Trust’s website lists more than a dozen states that do not require such checks.

Rhode Island recently joined New Hampshire and New Jersey in requiring prescribers to check the database first.

“When you switch that requirement to mandatory, it is amazing how dramatic the drop in prescriptions for opioids is,” Mr. Johnson said. The decrease can be as high as 30%, he said.

People will cross state borders to avoid database checks, said Mark Pew, senior vice president at Duluth, Georgia-based medical management company Prium.

Some three dozen states in the West and South do not mandate a database check before prescribing narcotics, but most do have drug monitoring laws, he said.

Mr. Pew said there has been a movement among the medical and workers comp communities for prescription monitoring information to be shared regionally and even nationally.

“It’s not a huge leap to link all these together, as long as states are willing to spend the money to do so and we are seeing more states that are willing to invest the money,” Mr. Pew said.

Ms. Cooper said New England governors are trying to find a way to coordinate the sharing of data from prescription drug monitoring programs across state lines, which she said will prevent injured workers that “doctor shop” across state lines.

Experts say education is an important component of efforts to curb narcotic addiction and overdoses.

For instance, Massachusetts’ new law requires opioid education for medical school and high school students, as well as for patients receiving opioid prescriptions, said Brian Allen, Westerville, Ohio-based vice president of government affairs for the workers’ comp division of Optum.

“It’s probably the most comprehensive bill for this that we have seen,” Mr. Allen said of the Massachusetts law.

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