The misuse of opioids, especially painkillers, has become an epidemic in the United States.
More than 900 people die weekly from opioid-related abuse. This trend has necessitated the formulation of new laws in places like the Treasure Coast. Millions of Americans are grappling with opioid addiction, and the death toll is at its peak.
Besides causing health risks to users, the misuse of pain medication poses a threat to national economic growth. Experts say that the problem began with doctors prescribing medications more often than necessary. The situation became worse because of the influx of cheap synthetic opioids in the market.
The government has increased its efforts in recent years to limit access to opioids. It has worked towards cutting the foreign and domestic supply of the drugs. Both federal and state officials on the Treasure Coast have also shifted their focus.
Instead of punishing drug users, they now aim to treat and rehabilitate them. The state has also introduced new pain medication laws. Here is the current status of opioid use on the Treasure Coast.
What Are Some of the Opioids Contributing to the Crisis?
Opioids refer to drugs from the opium poppy plant, and they fall into two categories. One is legally manufactured pain medications, and the other is illicit narcotics. Pain medications that have caused this epidemic include hydrocodone, oxycodone, and morphine.
These medications gained popularity among doctors as prescriptions for cancer and surgical treatment. In the past few years, the prescription for the drugs for chronic pain and joint pain has become rampant. This is despite the safety and legal concerns surrounding them.
Another point of concern is the infiltration of synthetic painkillers like fentanyl into the market. The drugs have high potency and hence are labeled “manufactured death” by law enforcement officials. Deaths from fentanyl are typically due to their illegal use, with their components being more lethal than heroin.
The CDC says that painkillers are often used in combination with other drugs for a higher impact. The combination increases the risk of overdosing.
How Bad Is the Epidemic?
Deaths related to overdosing by the illegal use of painkillers have been on the rise. Health experts relate the rising death toll to the overprescribing of painkillers. Physicians continue to prescribe the drugs today despite the concern that pain remains untreated.
The fact that pharmaceutical companies were advertising the drugs didn’t help the situation. The information they provided to the market was that the drugs posed little health risks. This caused patients to pressurize health-care providers to prescribe the drugs.
The patients were opposed to alternative treatment options.
Opioid-related deaths are also related to the high use of heroin. When users can’t get enough of the prescribed drugs, they use heroin to feed their growing addiction. The epidemic didn’t exist until there was a surplus supply of the opioids in the form of painkillers.
Socioeconomic Consequences of Opioids Dependence
The opioids epidemic has created devastating effects, both on the Treasure Coast and in a significant portion of the United States as a whole.
In health matters, it has led to the higher rates of HIV infection and hepatitis that we see today. The use of shared syringes among the users has contributed to the situation.
Pregnant mothers who have a high dependency on opioids may also pass the addiction on to the unborn child. This crisis has led to the rising numbers of children who end up in foster care for lack of parental responsibility.
Opioids are taking a toll on the economy. Dependency on the drugs renders the prime-age population non-productive.
An example is a manufacturing company in Ohio. It reported that at least 25% of job applicants fail their drug tests.
This shortage in the workforce costs the company approximately $800,000 yearly.
Florida’s Pill Mill Laws on Prescription Painkillers
In light of the adverse effects of the illegal use of opioids, Florida has put up new laws to regulate their access. The Department of Law Enforcement says that the drugs are worth more than $1 million on the street. The effort by the government to crack the pills down has resulted in a decrease in their use.
The changes are especially visible in the use of Vicodin and Oxycodone.
In 2010, Florida had put in place stringent laws regulating pain management facilities. Under the law, clinics had to get registration from the state.
Doctors weren’t allowed to dispense opioids from their facilities. Previously, doctors could sell the opiates to walk-in patients who wanted them.
In 2011, the state introduced a program through the Prescription Drug Monitoring Program. It provides healthcare providers with detailed information about a patient’s drug prescriptions history. The data reflected a significant drop in the use of opioids after the law took effect.
In figures, there was a decline of 500,000 5 mg Vicodin pills every month. From a policy perspective, the decline was because of the new laws. The trends point to the way forward in the future, indicating the need for policies that’ll regulate the use of opioids.
By the time of policy formulation, researchers found that 37 million prescriptions were for opioid painkillers. South Florida had become the epicenter of nationwide prescription painkillers on the black market. A year after the law took effect, the number of prescriptions for opioids went down by only 1.4%.
Upcoming Policy Changes
Federal and other regulations are changing in relation to opioids. National Community Pharmacists Association had a discussion on “Opioid Pain Management and Your Pharmacy.”
They discussed three aspects of pain management. The best practices for opioid prescriptions and abuse prevention in pharmacies were among topics of concern.
The organization came up with several recommendations to provide lasting solutions to the crisis. Among the suggestions was the expansion of electronic prescribing for controlled drugs. They also encouraged the prescription of alternative pain management options like acupuncture.
Another recommendation was to establish limits to the maximum supply of certain drugs per day. This recommendation has brought about a care coordination safety audit. Under the inspection, a person’s cumulative morphine milligram equivalent (MME) shouldn’t exceed 90 MME.
The organization also came up with prescription drug monitoring programs (PDMPs). These programs will ensure that pharmacies are operating under this new policy. They should control the access of opioids not given under a prescription.
There’s also increased access to medication for the treatment of opioid addiction and abuse.
Implementation of the Policy Changes
The discussions by NCPA were ongoing at the time the Congress was passing sweeping changes to rules affecting the opioid crisis. Most of the new policies will start immediately, but some won’t take effect until 2021. The medical sector is moving to an electronic system of prescribing controlled substances.
With the new policies comes a drug management program, also known as a lock-in program. The plan is to lock patients to one or more specific pharmacies for these frequently abused drugs.
The description of commonly abused drugs is at the discretion of the Human Health Services secretary. The secretary will also determine the identification process of patients eligible for the lock-in.
Another change they’ll put in place is hard safety edits for opioids. The policy instills a seven-day limit on opioid prescriptions for acute pain. They will monitor the 90 MME daily limit on a real-time basis for all prescriptions.
The only exception will be for patients in hospice care, undergoing cancer treatment, or end-of-life care. According to NCPA, the 90 MME limit will affect only a small population of patients. All the same, the policy will remain in place as with time, and the population will expand.
How Pharmacies Should Respond
The discussion revolved around policies pharmacies should put in place for controlled substances. Their regulations should capture the crucial information from a patient, and geographical limits to prescriptions. Pharmacies should also check new programs from the PDMP within a stipulated time.
The policies guide pharmacies on what to do if patients refill their prescriptions too often or too early. In matters of security, there’s a need to add GPS trackers and security cameras to ensure oxycodone and Oxycontin remain locked up at all times.
How Will the New Laws Address the Opioid Epidemic?
President Donald Trump passed the bill against the opioid epidemic. The following changes will take effect during implementation.
Prevention Programs
The new law targets substance use-disorder prevention for patients and communities. It aims at modifying many aspects of the epidemic, with many provisions to expand preventive programs as well. It believes in eliminating all barriers to successful treatment of substance use disorders (SUD).
The existing programs will be expanded to create new ones that also limit overdosing. The programs will strive to enhance medication-assisted treatment (MAT). This will also affect the reauthorization of the National Drug Control Policy office.
The MAT program will lift restrictions on the spending of Medicaid dollars. This especially applies to residential addiction centers. Such facilities will be allowed to accept payments for residential SUD services.
In this case, Medicare will cover MAT treatment options like methadone.
Funding
Treatment programs in residential facilities will have increased funding from the state. These will target pregnant and postpartum women. The policy will make it necessary for the CDC to create education materials targeting pregnant women.
The main discussion around treatment programs for women is pain management during pregnancy. Women will take the center stage in the making of decisions since the policy targets them.
Payment Models
An alternate payment model will be introduced through the policy. This is following the demonstration project by the American Society of Addiction Medicine.
The society worked in collaboration with AMA. They ensured increased access to evidence-based outpatient treatment for opioid use related disorders.
In the same breath, there’ll be provision repayment for health professionals treating SUDs. This will be offered on condition that they agree to work in mental health professional shortage areas. The bill stipulates that the professionals can provide care in community-based settings.
However, the communities have to be the worst hit by drug overdoses. This will form part of their service requirements and obligations.
Limited Flow of Illegal Opioids
The law will curb the influx of synthetic fentanyl that finds its way into the country through the mail. This will be useful in helping curb opioid-related deaths linked to fentanyl and heroin.
Research and Development
The law will also encourage research and increase funding for the same. There’s still a wide gap that needs to be filled in the development of non-addictive painkillers. The process of developing drugs should aim at eliminating opioid medications from the market.
The HHS department will have the mandate to study and report to the Congress on the effects of the new laws. It should mostly look at regulations that limit the dosage and length of administration of opioid prescriptions.
The Mandate of Key Players
The law touches on the commission of AMA on physicians. It also outlines the many requirements in federal and state-controlled programs. One provision is for physicians to make use of electronic prescriptions for controlled substances by 2021.
The Drug Enforcement Administration should update its regulations on the authenticity of prescriptions. The administration will use biometrics in keeping up with the changing technology.
The AMA task force will encourage physicians to:
- Enhance education and training
- Register and use state PDMPs
- Be in the front line to end the stigma
- Support comprehensive pain treatment
- Safely store and dispose of opioids and all medications
The law also touches on the mandate of the Food and Drug Administration. The FDA should develop guidelines for the prescription of acute pain where guidelines don’t exist.
Treasure Coast – Take Away
The scope of the new pain medication law is broad. Since its implementation, it has brought changes in the use of opioid painkillers. In places where their use was rampant, like on the Treasure Coast, the trend has changed.
The federal government has been able to curb the illicit flow of the opioids. In the few coming years, there’ll likely be more improvement. The changes will be more profound when some sections of the legislation come into effect.
The shift from punishing users to prevention and treatment is reducing opioid-related misuse.
If you’re on Treasure Coast and you want help in opioid addiction, be sure to contact us, and we’ll be glad to help you.