INDIANA — An Indiana bill that would limit overprescribing opioids has passed the senate committee on public health and awaits a house vote.
Senate Bill 226, if passed, would limit a prescription for opioids to seven days for an adult being prescribed the drug for the first time, or a child under 18 years old — a measure its proponents say could go a long way toward fighting the opiate epidemic in Indiana.
The bill would allow prescribers to use their professional opinion to determine if a longer dose would be needed, such as in cases of cancer, palliative care or as a medical treatment for substance abuse. Documentation would be required to show that an opiate was the most appropriate drug to prescribe.
Patients, their caretakers or guardians would also be able to request a smaller amount of the drug, which would also be documented.
Dr. Jerome Adams, Indiana State Health Commissioner, testified Wednesday in the committee session in favor of the bill as a way to help mitigate the state's drug crisis.
“As a state, we are at a critical crossroads in our battle against drugs,” he said. “One of the biggest contributors to this epidemic is the overprescribing of powerful painkillers.”
He presented statistics revealing that Indiana has the highest rates of opioid prescriptions, with nearly 80 percent of heroin users saying their usage started with a prescription opioid. Allowing doctors to prescribe less and patients to request less also means there won't be extra pills sitting around, and would decrease the likelihood of addiction.
The Centers for Disease Control and Prevention recommends that the lowest effective dose be prescribed, which is usually three days or less.
Adams pointed to national initiatives in the late 1990s that introduced the concept of pain as the fifth vital sign.
“This concept was a well-intentioned attempt to address untreated pain but it has not improved the treatment of pain,” he said. “Instead, it has led to a society of citizens who expect to live pain-free and believe opioids are the key to doing so.”
The legislation would give physicians a legal backing to give them options in prescribing based on the illness and the physician’s professional opinion, and legal protection to refuse an opioid.
“Fixing this problem isn't as easy as telling doctors to quit prescribing opioids,” Adams said. “Opioids do have a purpose in pain management when used in moderation. It's important to also consider pain management techniques that don't involve addictive drugs.
“That can be hard to do in today's society, when we have an entire generation of doctors who were taught that pain management was a standard of care.”
Practices outlined in the bill have been outlined in Massachusetts, Connecticut, Rhode Island, Maine and New York and Adams believes it can strengthen Indiana's defenses against opioid addiction.
“Keeping unnecessary opioids out of medicine cabinets and off the streets is a key component in our fight against the drug epidemic,” Adams said in a news release. “While opioids do have a role in pain management, empowering prescribers to make the safest choices for their patients will help save lives in Indiana. That’s simply good medicine.”