(Editor's note: This story was modified after publication to correct a description of naloxone.)
A bill that is moving quickly through the Senate aims to stem opioid abuse by supporting non-addictive treatments and helping primary care physicians identify patients who are seeking too many prescriptions.
The Comprehensive Addiction and Recovery Act(www.congress.gov) is sponsored by Sens. Sheldon Whitehouse, D-R.I., and Rob Portman, R-Ohio, reflecting the strong bipartisan support for action on the opioid issue.
In a March 1 letter,(2 page PDF) AAFP Board Chair Robert Wergin, M.D., of Milford, Neb., commended Whitehouse and Portman, praising some elements of their legislation as well as pointing out flaws they should address. He noted that funding for a comprehensive prescription drug monitoring program in the legislation, which would allow physicians to track how frequently patients receive prescriptions, could alleviate the public health threat caused by opioid abuse.
"Family physicians in states with prescription drug monitoring programs find such databases useful tools in treating patients and in preventing diversion," Wergin said.
He also praised a public awareness campaign that the legislation calls for.
"Family physicians recognize the value of increased public education about the risk of abuse of prescription opioid drugs if such products are not taken as prescribed," Wergin said.
The AAFP also supports the legislation's funding of treatment and prevention programs, including wider use of naloxone. The bill would allow emergency workers to administer drugs that can reverse the effects of opioid overdose and would shield anyone who administers naloxone from prosecution for practicing medicine without a license.
In addition, the AAFP supports the bill's mandate for multiple federal agencies to cooperate on expanding sites where individuals can safely dispose of any unwanted prescriptions.
But Wergin pointed out troubling flaws in the legislation that need to be corrected. For instance, the bill would create a task force to craft a set of "best practices" for physicians regarding medication that is subject to the Controlled Substances Act. If the task force were to require CME credits at the federal level in order for physicians to maintain their license to continue prescribing opioids, it could be especially burdensome to physicians in states that already have similar requirements.
"The AAFP opposes action that limits patients' access to pharmaceuticals prescribed by a physician using appropriate clinical training and knowledge," Wergin said. "The creation of additional prescribing barriers for primary care physicians would limit patient access when there is a legitimate need for pain relief."
The bill also could restrict a physician's ability to prescribe needed medication and prevent a patient from obtaining it. In an attempt to reduce the spread of "doctor shopping" for multiple prescriptions, the bill would "lock in" Medicare Part D beneficiaries to a single physician who could write prescriptions and a single pharmacy that could fill them. The AAFP has previously said such "lock in" could prove too difficult if a patient were traveling.
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