{"id":23017,"date":"2018-01-26T18:35:09","date_gmt":"2018-01-27T00:35:09","guid":{"rendered":"http:\/\/update.legislature.ne.gov\/?p=23017"},"modified":"2018-01-26T18:35:09","modified_gmt":"2018-01-27T00:35:09","slug":"tighter-controls-on-opiate-prescriptions-considered","status":"publish","type":"post","link":"https:\/\/update.legislature.ne.gov\/?p=23017","title":{"rendered":"Tighter controls on opiate prescriptions considered"},"content":{"rendered":"

The Judiciary Committee heard testimony Jan. 26 on two bills that seek to tighten restrictions on dispensing opiates in Nebraska.<\/p>\n

\"Sen.
Sen. Sara Howard<\/figcaption><\/figure>\n

LB931, sponsored by Omaha Sen. Sara Howard, would limit opiate prescriptions for a patient younger than 19 to no more than a seven-day supply. Under the bill, a medical practitioner would be required to discuss the risks associated with opiates with the patient\u2019s parent or guardian. Exceptions to the seven-day limitation could be made for chronic pain, cancer diagnosis or palliative care.<\/p>\n

Howard said her sister Carrie, who developed an addiction to prescription pain medication and died of an overdose in 2009, was her inspiration for bringing legislation to combat the opioid problem in Nebraska. Recent successes, she said, include implementation of the state\u2019s prescription drug monitoring program, which was the first of its kind in the country.<\/p>\n

\u201cIn the past three years, Nebraska has taken great strides in the fight against opioid addiction,\u201d Howard said. \u201cI think that LB931 is an important step in a long process in this state in combating opioid addiction.\u201d<\/p>\n

Dr. Andrew MacFadyen, testifying on behalf of Children\u2019s Hospital and Medical Center, supported the bill. Calling opioids a \u201cdouble-edged sword,\u201d he said that the medical center has seen an increase in the number of young people who have attempted suicide using the drug.<\/p>\n

\u201c[The bill] would actually limit the amount of opioids available to be abused \u2026 reinforce to providers that opioids can be dangerous and encourage providers to move toward pain relief alternatives that are less risky by breaking them out of their current prescribing habit,\u201d MacFadyen said.<\/p>\n

Kim Robak also spoke in support, testifying on behalf of the Nebraska Dental Association. She did suggest, however, that the bill should have an expiration date. She said that guidelines for opioid use were much different when the drugs first became available and they likely will change again in the future.<\/p>\n

\u201cFive years from now, or seven years from now, a seven-day prescription may be wrong,\u201d Robak said. \u201cIt may be two days or one day \u2026 and we want to make sure that we can look at this [a few years from now] and make sure that it is doing what we want and that it\u2019s not causing some harm that we didn\u2019t intend.\u201d<\/p>\n

John Massey of the Nebraska Medical Association testified in opposition to the bill, saying the state should give a recent pain guidance document developed by the state Department of Health and Human Services time to alter clinician behavior before legislating solutions.<\/p>\n

Limiting opioid use and abuse is an important goal, he said, and the best way to do so is through evidence-based practices that focus on root causes. One fear, he said, is that clinicians will see the seven-day maximum and prescribe accordingly, when they should focus on the smallest dose possible for the shortest period of time possible.<\/p>\n

\u201cI\u2019m afraid this bill isn\u2019t going to accomplish what we want it to\u2014or it might actually accomplish the opposite of what we\u2019re trying to do,\u201d Masse said.<\/p>\n

LB933, sponsored by Omaha Sen. Brett Lindstrom, would require medical practitioners to notify patients\u2014or a parent or guardian of a patient under 18\u2014of the risk of addiction and overdose when prescribing opiates and other Schedule II prescription medications. The notification would be required prior to the initial prescription and again before issuing a third prescription.<\/p>\n

Lindstrom said his family has had first-hand experience with opioid addiction, which started with prescription medication for back pain and escalated to drug shopping. Opioids can be extremely addictive even when taken as intended, he said, and the U.S. has seen a 200 percent increase in drug overdose deaths over the past 15 years.<\/p>\n

\u201cIt is no secret that prescription drug abuse, specifically with opioids, is a national crisis,\u201d Lindstrom said.<\/p>\n

Under the bill, a practitioner would be required to discuss the risks of addiction and overdose, including:
\n\u2022 reasons why the prescription is necessary and alternatives that may be available;
\n\u2022 controlled substances and opiates are highly addictive even when taken as prescribed;
\n\u2022 there is a risk of developing a physical or psychological dependence on opiates or controlled substances; and
\n\u2022 taking more controlled substances or opiates than prescribed, or mixing sedatives, benzodiazepines or alcohol with controlled substances or opiates, can result in fatal respiratory depression.<\/p>\n

A notation in the patient\u2019s medical record of the discussion would be required.<\/p>\n

Gregory Lauby testified in support of the bill, saying he was given an opioid following surgery and was told only that he should not drive while taking it. Possibly the most important measure that could be taken to help the current crisis is to better educate patients, he said.<\/p>\n

\u201cI think it would go a long way if physicians or nurses or someone at least alerts the person who is receiving the medication about what dangers it can pose and cautions them to follow the prescription procedures that are set out,\u201d Lauby said.<\/p>\n

John Massey, again testifying on behalf of the Nebraska Medical Association, opposed LB933, saying it would intrude upon the doctor\/patient relationship. He said he \u201ccan\u2019t imagine\u201d that any physician is not already having the conversation outlined in the bill with their patients when prescribing opioids.<\/p>\n

The committee took no immediate action on the bills.<\/p>\n","protected":false},"excerpt":{"rendered":"

The Judiciary Committee heard testimony Jan. 26 on two bills that seek to tighten restrictions on dispensing opiates in Nebraska.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"colormag_page_container_layout":"default_layout","colormag_page_sidebar_layout":"default_layout","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[13],"tags":[85],"class_list":["post-23017","post","type-post","status-publish","format-standard","hentry","category-judiciary","tag-sen-sara-howard"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=\/wp\/v2\/posts\/23017","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=23017"}],"version-history":[{"count":2,"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=\/wp\/v2\/posts\/23017\/revisions"}],"predecessor-version":[{"id":23019,"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=\/wp\/v2\/posts\/23017\/revisions\/23019"}],"wp:attachment":[{"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=23017"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=23017"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=23017"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}