BOSTON (Legal Newsline) — A Massachusetts law regulating opioid painkillers is said to be the most comprehensive in the nation and contains a provision that restricts first-time prescriptions to a seven-day supply.
The law, signed in March by Massachusetts Gov. Charlie Baker, had broad support from legislators, health care providers and law enforcement professionals. It was a response to an ongoing crisis in the commonwealth, which is seeing 100 deaths a month from opioid overdoses, according to government statistics.
Karen Gibbs, an attorney with McDermott, Will and Emery, said that the Massachusetts legislation is part of a broader trend.
Earlier this month, Connecticut passed legislation that also limits first-time opioid prescriptions to a seven-day supply. A recent law in Wisconsin has some similar provisions to the Massachusetts law, including requiring opioid prescriptions to go through a state database. Other states, including New Hampshire, have issued guidelines for prescribers.
“I’m not aware of any pending legislation in other areas, but I would be surprised if it doesn’t exist," Gibbs recently told Legal Newsline. "(People recognize) that opioids are a gateway drug to heroin, which is a problem that’s exploded over the last few years.”
The Massachusetts law stands in contrast to legislation pending in Congress and guidelines released earlier this year by the U.S. Centers for Disease Control. The House passed more than a dozen bills earlier this month dealing with opioid addiction, while the Senate passed a comprehensive bill in March. Those measures would expand the availability of addiction treatment and boost law enforcement efforts.
The CDC guidelines recommend ways to curb addiction through education, patient monitoring and lowering dosages.
“It’s unusual to have a specific limit on prescriptions,” Gibbs said. “You usually would see guidelines like the ones the CDC issued earlier this year or requirements about education. The medical community likes to have leeway when prescribing drugs.”
Baker had originally proposed limiting first-time opioid prescriptions to three days, but legislators and medical professionals balked at that restriction. The law passed unanimously with the seven-day supply provision, and had the support of medical, dental and pharmaceutical organizations.
Because the law focuses on doctors and prescribers as opposed to pharmaceutical companies, Gibbs said she didn't think it would likely be used by lawyers planning to file suit against the manufacturers of opioid painkillers.
Other provisions of the law include a requirement that schools screen students considered at risk for substance abuse and that anyone admitted to an emergency room for an opioid overdose be given a substance abuse evaluation.
In addition to requiring physicians and dentists who are going to prescribe opioids to check a state registry that lists all of the drugs a patient has been prescribed, and several provisions to improve education and addiction prevention programs, the law also allows patients to decline opioid prescriptions entirely and to accept partial refills of opioids, instead of taking the full prescription.
This provision recognizes that many opioid addicts take unused pills that friends and family might have in their homes, Gibbs said. Because it’s difficult to get rid of unused prescription medicines, partially used bottles of opioids often remain in homes.
“It’s harder than people might think to get rid of unused pharmaceuticals," Gibbs said. "Pharmacies aren’t allowed to take back prescription drugs.
"The DEA and local law enforcement agencies have what’s known as take-back programs for controlled substances, but there aren’t as many of those as you would think, so there are a whole lot of prescription drugs sitting unused in medicine cabinets.”