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Bill targets prescription drug abuse

Posted June 11, 2014

— A bill aimed at curbing prescription drug abuse in the state gained the approval of the Senate Health Care Committee on Wednesday.

The measure would revive and strengthen a defunct program that tracks the prescriptions of Medicaid patients who use controlled substances such as opioid painkillers, which lawmakers say are at the heart of a statewide addiction epidemic.

The program, which hasn’t operated since last July due to technical issues with the state’s Medicaid billing system, prevents “doctor shopping” – obtaining several prescriptions from different doctors – by requiring some Medicaid patients to receive controlled substance prescriptions from only one doctor at one pharmacy.

Proponents of the bill said prescription drug abuse often looms over military communities, where disabled and injured veterans can become dependent on painkillers.

Accidental prescription drug overdose deaths have tripled in large swaths of the state in a decade, according to an April report by the legislature’s Program Evaluation Division. Fatal overdoses are estimated to cost public and private insurers $72.5 billion a year nationally.

“This bill is absolutely necessary to keep us going in the right direction,” said primary sponsor Sen. Ben Clark, D-Hoke. “This is imperative that we move forward on this.”

The bill calls for state health officials to develop new guidelines for opioid prescribers and requires doctors to take continuing education classes on prescription opioid abuse.

But the legislation doesn’t address the pressure on doctors to appease drug-seeking patients – or risk losing their jobs – due to hospitals’ increasing emphasis on patient satisfaction surveys, said Dr. Sandra Brown, a physician who spoke at the committee meeting.

Brown opposes the provision requiring additional classes, saying the problem isn't caused by a lack of education on drug abuse.

“It comes from individual providers who know right from wrong, but who are under tremendous pressure to create satisfied patients,” she said. “The physician knows that he or she has absolutely no recourse, that the options are (to) start the supply chain or have an unhappy patient whose survey result may lead to a reduction in compensation or actual termination."

Bill co-sponsor Sen. Fletcher Hartsell Jr., R-Cabarrus, said he hopes to alter the bill’s language in the future to help ease the burden on prescribers.

“Hopefully, we’ll have the time to do it,” Hartsell said. “There is an extraordinarily perverse incentive for prescribers to face the kind of situation that Dr. Brown has indicated.”

The legislation would also streamline the database used to monitor these drugs, expanding access to the federal Drug Enforcement Administration and monitoring systems in neighboring states to better regulate opioid trafficking and doctor shopping across the state borders.

Upgrading the database would help law enforcement agencies, prescribers and pharmacies identify and prevent drug abuse, Clark said.

“You have a lot of data in a lot of different pockets,” he said. “When various systems become aligned, they will be able to communicate together and provide a complete picture of what is going on with regard to prescription drugs in the state.”

The bill’s next stop is the Senate Appropriations Committee.

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  • smdrn Jun 11, 2014

    The first thing healthcare providers are taught about pain management is that pain is what the patient says it is. What might be a mild annoyance to some, is a 10 out of 10 to others since they've never had pain before. Long term pain med use needs to be followed closely and patients need to be weaned off the med instead of stopping abruptly. Like another poster mentioned, dependance and addiction are two different animals.

    There are pill mills that need to be addressed, but I have found that most patients are under-medicated and their pain not adequately controlled versus those lavished with pills and refills. I had to fight to get my father's pain controlled. After one of his doctor's finally wrote him to have a narcotic patch, he was able to get around more. Instead of walking hunched over a walker, he is able to walk upright with a cane. His quality of life greatly improved. I see this bill taking away the quality of life for many.

  • Setnitst8 Jun 11, 2014

    Dependency and addiction are two very different things. It's ok to be dependent on painkillers, if you need them to function in society, and yes some people DO need them. Addiction is something different. So you must be careful in this war on painkillers, to not take them away from those who need them.

  • juliomercado Jun 11, 2014

    Prescription drug abuse is the new killer and this bill is a good start at addressing it. Kids today are more interested in Xanax or Hydrocodene than pot.