In Florida, one of the states hardest-hit by the opiate epidemic, Gov. Rick Scott recently called for state legislators to impose a three-day limit on opioid prescriptions.
The proposal for limiting opiate prescriptions to a three-day supply is based on a recent study from the Centers for Disease Control and Prevention (CDC) showing how quickly a user can get hooked on opiate painkillers.
The study found that, with a prescription for a 10-day’s supply prescription, about 20 percent of patients become long-term users. For patients who get a 30-day stash of opioid all at once for their initial prescription, the chance of being on opioids for a year rose to 45 percent. But, researchers said only about 7 percent of patients get such long-duration prescriptions in the study.
A few other states have imposed similar limits. Ohio prohibited doctors from prescribing more than seven days of narcotic pain pills for adults or more than five days for minors. Massachusetts limits the supply to seven days. New Jersey mandated that first-time prescriptions for acute pain cannot exceed a five-day supply. It exempted patients being treated for cancer or under hospice care.
Scott also said he wants to is require all health-care professionals who prescribe controlled substances to participate in the Florida Prescription Drug Monitoring Program.
Scott’s office also plans to seek additional reforms such as: Fight unlicensed pain management clinics ; Requiring education on responsible opioid prescribing; creating more opportunities for federal grants
Scott is also calling for more than $50 million for substance abuse treatment, counseling and other recovery services.
Florida faced a crisis earlier this year when $20 million in federal block grants for mental health and substance abuse care expired, effective on June 30, says Mark Fontaine, who is president of the Florida Behavioral Health Association and executive director of the Florida Alcohol and Drug Abuse Association.
“There wasn’t a lot of conversation that the $20 million would be going away, it just hit on June 30, so providers had to shut down some services. It was a one-time grant,” Fontaine told The Influence.
The state made up for some of that with $27.1 million in federal funding for the opiate crisis. Because the Florida governor had declared a state of emergency, “we were able to waive some rules and get the money in the hands of providers by the end of May.”
In May, officials from three state agencies went on a “listening tour” to hear local concerns about the epidemic in Palm Beach, Bradenton, Orlando and Jacksonville. “One thing they heard was a lack of capacity to effectively serve patients,” Fontaine says.
That’s nothing new, he says. “The system has been constantly challenged trying to serve all of the people who need care, both in substance abuse and mental health.”
State authorities have identified a disconnect between hospital ERs where addicts are treated for overdoses, and treatment providers. “One of the priories people are looking at is how to build bridges between ER departments and treatment providers. In a lot of places there is not a formal mechanism for that to take place.” The state is providing grant money for an ER bridge program, Fontaine says.
Fontaine is trying to locate data to indicate the size of the gap between available detox beds in the state and the number of addicts who need treatment. “We know how many publicly funded detox and residential beds there are, but we don’t know the waiting list numbers.” One residential provider told him they have a five-week wait.
But Fontaine sounded cautiously optimistic. “The governor, Senate and House are all taking a very careful look at how to address the epidemic not only with funding and making treatment more available, but also in addressing the governor’s proposals.
“So, I think we have growing momentum in Florida to look at how to address the opioid problem to reduce deaths and help people find recovery, and address some of the policy issues.”