By Michael Hill
New Jersey Attorney General Chris Porrino has sent a letter to the state Board of Medical Examiners under the Division Consumer Affairs. The board licenses, regulates and disciplines doctors. Porrino relies on statistics to demonstrate why the rules for prescribing opiates for acute pain must change. He says overdose deaths keep rising and so does the use of naloxone to reverse an overdose. The use nearly doubled from 2014 to last year.
“We do have some numbers already in 2017 which suggests the problem is not going away,” Porrino said.
Porrino tells prescribers the administration will follow guidelines from the Centers for Disease Control and Prevention. The CDC recommends the lowest effective dose only for the length of the pain, no “just in case” prescriptions and doctors should re-evaluate patients if acute pain continues, confirm or reverse the first diagnosis and if necessary adjust the pain management which could include alternatives to medicine.
“I want to limit it to five days,” said Gov. Chris Christie earlier this month.
Acting on the governor’s State of the State address, Porrino’s letter tells the medical profession the Christie administration is revising the rules from a 30-day initial opiate prescription to a five-day supply for acute pain, not for cancer or end-of-life care.
“Rather than having to deal with law enforcement and prosecution and potentially jail after you become addicted, or worse death and illness, we’re trying, through this measure, to prevent people from getting addicted,” Porrino said.
“I think that’s reasonable. I don’t think that’s intruding on a physician’s ability to treat patients. But another thing is we need to educated ourselves a lot better,” said Psychiatrist Michael Shore.
A handful of states have seven-day supply limits.
The American Medical Association says overly restrictive public policies can lead some patients to turn to dangerous alternatives and street drugs.
And while the New Jersey Medical Society praises the governor’s focus on addiction, it says limiting prescriptions would have unintended consequences: “Unfortunately, statutory medication limits decrease the quality of care and life for pain patients. The Medical Society of New Jersey opposes such intrusions into the practice of medicine, especially if they do not take into account individual patient circumstances, like medication tolerance or access to insurance, transportation or alternative treatments.”
Porrino says he’s listening to the medical profession but the profession should hear this — this administration is sending no signals that it’s backing away from its prescribed limits on the five-day supply of opiates.