Opinion: Patients should be aware of side effects from opioid reforms
The way physicians treat pain is changing. So are the laws that regulate pain medicine.
Patients who have been to the doctor’s office this month may already be feeling the pinch as new state regulations go into effect. As others seek treatment or prepare for surgery in the coming months, the number and impact of these changes will only grow.
It is important that patients understand Lansing’s latest restrictions impacting their care.
So what’s different?
For years, Michigan physicians have used a prescription drug monitoring system called MAPS, to ensure prescription drugs – including opioids – aren’t overprescribed. Under a new law that went into effect at the beginning of June, every controlled substance must now have a MAPS online check when the prescription is written. For patients being discharged from a hospital who receive more than a three-day supply of opioids, physicians are also now required by law to look up every patient in the monitoring system.
New “patient education” requirements have also gone into effect. In addition to the normal education every physician provides at every office visit, under the law, physicians are required to provide each patient receiving an opioid with educational materials on the dangers of opioids, their safe use, and their safe disposal. After this additional “education,” patients are also required to sign a state form.
These mandatory checks, education, and paperwork are likely to stretch patients’ office visits a bit longer than many are used to.
Yet another change came out of Lansing on July 1, when physicians were limited by lawmakers to prescribing no more than a seven-day supply of an opioid for patients in acute pain from surgery or an injury, even when severe pain and recovery times may stretch well beyond a single week.
In those instances, patients are required to contact their physician again for additional treatment, and additional prescriptions. That may mean additional trips to the doctor’s office, and additional waits for prescriptions.
Our state is among the worst in the nation when it comes to annual drug overdose deaths, and most of those are connected to opioid pain killers and heroin, the illegal substitute many turn to when their supply of illegal pills are exhausted. Nearly 1,700 Michigan residents lost their lives to an opioid related overdose in 2016.
Physicians are their patients’ best advocates, and have taken a prominent leadership role combatting this health crisis, and physicians have championed and enacted critical reforms.
Over the last four years, physicians nationwide have reduced the number of opioid prescriptions by more than 55 million – a 22.2 percent drop. That number includes a 9 percent decrease between 2016 and 2017 alone.
Just last year, physicians also more than doubled the number of prescriptions for naloxone, to nearly 8,000 per week.
And in Michigan, it was physicians who for years have lead the charge for an effective prescription drug monitoring program like MAPS to further curtail the number of pain killers in circulation.
Policymakers have implemented these new regulations on your care in an attempt to address a very real crisis. They include some that will help curb the opioid problem, and others that will make it more challenging to manage patients’ pain.
Whether they are heading in for surgery, an appointment with their primary care doctor, or to treat pain connected to an injury, illness, or disease, it is important that patients know what to expect, before their next visit with their physician.
It is also important that policymakers in Lansing and Washington, D.C., work with patients and their physician advocates on additional reforms, and fixes that safely address these side effects whenever possible, while better combating the opioid epidemic.
That means embracing a broader range of solutions to address the crisis; providing patients with a broader range of treatment options and FDA-approved medications; and empowering physicians, health care professionals and treatment centers to better meet the needs of patients – including those struggling with addiction.
That also means better access to providers, facilities and treatments, and empowering physicians with a bigger tool box (and less red tape) to treat addiction.
Betty Chu, M.D., is the president of the Michigan State Medical Society and Chief Medical Officer and Vice President of Medical Affairs for Henry Ford West Bloomfield Hospital.