New Michigan opioid laws may mean longer prescription wait times

Karen Bouffard
The Detroit News

New state laws to reduce patients' risk of opioid addiction go into effect Friday as part of a package of measures passed in December to curb overdose deaths in the state.

Michigan lawmakers have passed new laws to deter prescription opioid drug abuse. They go into effect Friday, June 1, 2018, and July 1.

Effective Friday, prescribers of drugs like Vicodin, morphine, oxycodone and Tylenol with codeine are required to educate patients on the risks of addiction, and patients must sign a form saying they've been informed.

Prescribers are also required to check the patient's history on the Michigan Automated Prescription Surveillance (MAPS) system, which documents every controlled substance prescription written in the state.  Checking with MAPS will tell prescribers if a patient is "doctor shopping" for drugs. 

The laws could mean longer waits for prescriptions as doctors check the MAPS system and fill out paper work.  But Dr. Michelle Schreiber, chief quality officer for Henry Ford Health System, said the the changes could help save lives.

Michigan had 2,376 drug-related deaths statewide in 2016 — nearly a 20 percent increase over 2015, according to the most recent data from the Michigan Department of Health and Human Services.

"Especially initially as we’re all getting used to this, we may be asking more patients to come into the office for the education and getting the state form signed that they received their education,"Schreiber said Thursday. "For minors, parents need to be educated, and they need to sign that form as well.

"Michigan is one of the leading states in the country where patients are dying of opioid (overdoses.) So despite the fact that this might be a little additional work flow initially, we’re fully supportive of the law."

More changes are coming on July 1, when doctors will be limited to prescribing no more than a seven-day supply of opioid medication for patients in acute pain that's expected to be temporary — say from surgery or an injury. The change won't affect palliative care patients, or those  with cancer or chronic pain conditions.  

"Say you broke your leg, or something like that — frequently providers have been giving a month's supply of narcotic medications because that was pretty much the standard," Schreiber noted. "Now we are limited by law to a seven-day prescription.

"The rationale for that is that opioid addiction can begin as early as three to five days after starting these medications," she added. "Seven days was not an arbitrary pick on behalf of the lawmakers. There was some science behind that, that you can become addicted that early — especially in patients that haven't taken opioids before."

That doesn't mean patients can't get a refill, Schreiber noted.  Prescribers still will be able to phone in refills to the pharmacy — provided they check the MAPS system. But when patients are switched to a different medication, they will likely be asked to come back to the office for education and sign the state form.  

"I think some patients are going to be surprised when all of these laws take effect, because for the prescribers the inclination will be to prescribe less opioid medication," Schreiber said.

The new laws will encourage doctors and patients to try non-opioid treatments, like anti-inflamatory medications or acupuncture, she added. 

"But for the patient who truly has chronic pain, they will get their medication. For a cancer patient, we certainly don't want them to be afraid they won't get their medications, because they will."; @kbouffardDN