Limiting pain-med supply to 7 days among ways state leaders propose to fight opioid crisis

What Lisa Janicki wished she asked her son, and the pain she hopes no other family has to experience, compelled her to testify on a bill introduced in the state Legislature that would limit the supply of opioids doctors are allowed to prescribe in Washington.

What if she had asked more questions about her son Patrick’s OxyContin pill use — the painkillers he overdosed on on August 4, 2017? What if she checked in more often? What if she encouraged him to seek treatment?

“This story cannot end with Patrick,” Janicki, a Skagit County Commissioner, said Friday, Jan. 12, while testifying in support of a bill that would create limits to the length of opiate prescriptions.

The bill is one of at least seven introduced in the Legislature so far in the 2018 session, reflecting a bipartisan attempt to crack down on prescription opioids and their contribution to what officials have called a state health epidemic.

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Another bill, which was requested by Gov. Jay Inslee, would spend $2.3 million a year on expanding a statewide program connecting addicts with treatment, social services, employment and housing opportunities. The proposal would cover all facets of opioid addiction, including heroin use.

In the Legislature, Democrats have introduced a number of bills that would better connect people with services in an attempt to curb prescription opioid-related deaths in Washington. State health officials say there have been more than 5,000 such deaths since 2006. That rate has dropped in the past year, with 76 fewer deaths occurring in the first half of 2017 than had in the year prior.

Among the proposed legislation are bills that would require doctors to warn patients of opioid addiction before prescribing the drugs and add federal health records to the state’s patient prescription database to better track opioid use. Collection of unwanted or unused pills to prevent people from self-prescribing and ensuring addicts have access to health care services also have been proposed.

Another bill would, unless a doctor suggests otherwise, limit opiate prescriptions to a seven-day supply for patients older than 21 and a three-day supply for those under 21.

Some chronic-pain sufferers said they were concerned House Bill 2272 would make filling their prescriptions, which help them function, more difficult.

“That’s ridiculous,” Cindy Hadden, a Tumwater resident suffering from chronic back pain, said of the proposed limits after the bill’s hearing. “When you’re in pain and hurt, you don’t make room to do more work.”

In 2000, Hadden said she injured her spine while moving trade-show displays for her job at the time, leaving her with a pain she’s likened to Babe Ruth slugging her with a bat.

The bill’s sponsor, Rep. Eileen Cody, a Seattle Democrat, said her measure is aimed at limiting prescriptions to those suffering short-term pain and that it won’t affect people in Hadden’s situation.

Cody said she believes the proposal would draw support from across the aisle. A similar bill last year passed in the House but failed to make it to the Senate floor for a vote.

A handful of Republicans have introduced legislation of their own, but some have expressed concern over whether some measures are going too far.

“You’re going to have people in legitimate pain from legitimate surgeries who need pain management,” Rep. Michelle Caldier, a Republican from Port Orchard, said. “Some of these bills will make that very difficult.”

Caldier said she believed the bill would be onerous for patients who have to make co-payments every time they pick up their prescriptions. Rather than limit prescriptions, Caldier has advocated for a bill she introduced to wean patients off opioids by mixing them with less powerful painkillers.

The policy section on the website of Purdue Pharma, the pharmaceutical company which manufactures the powerful painkiller OxyContin, advocates for limiting prescriptions for first-time pain sufferers.

Janssen Pharmaceuticals, another prescription opioid manufacturer, did not comment on specific bills.

“We recognize opioid abuse and addiction is a serious public health issue,” Jessica Castle Smith, a spokesperson for the company, said. “We are aware of legislative initiatives underway at the state and federal level and will continue to do our part in finding ways to address this crisis.”

Inslee on Monday unveiled his proposal to expand so-called hub-and-spoke programs.

“We need to have a better way to prevent people from succumbing to this medical condition of an opioid addiction, and we need better treatment for people who should not be stigmatized and be denied medical treatment,” the governor told reporters at a news conference.

The networks help cut down on a cycle of incarceration among people who commit crimes to sustain their addiction, Inslee said. Six are already in place around the state, including locations in Bellingham, Seattle, Lakewood and Vancouver.

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“We simply cannot jail our way out of this issue,” Thurston County Prosecutor Jon Tunheim said at the Monday panel with the governor.

Incarcerating addicts “without treatment or medication and then releasing them to the community really does nothing to improve public safety,” Tunheim said.

The governor also has proposed applying for federally funded vouchers that would provide drug treatment to inmates while they serve time. Those vouchers would be requested through Medicaid, a federal health care program covering low-income people. While not yet guaranteed, one policy adviser close to the governor is optimistic the federal money would be approved in light of President Trump's recent declaration of a national emergency on opioids.

Top state Republicans said Tuesday they still were reviewing the governor’s proposal.

The current legislative push follows a string of lawsuits brought by state and local governments against pharmaceutical companies, tying the prescription opioid manufacturers to upticks in addiction and homelessness.

Attorney general Ferguson filed a lawsuit last year against Purdue Pharma for allegedly deceiving the public about the painkillers' effectiveness in treating chronic pain and its risk of causing addiction.

The City of Tacoma also is suing the prescription opioid manufacturer, along with two others, saying their products have contributed to the city's homelessness crisis and strained public health resources.