Opioid crisis: 'not a problem that's going to go away on its own'

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It seems that every generation has its own epidemic to battle. But unlike polio or cholera, the tragic epidemic of our time is one of our own making. Responsible for an estimated 115 deaths every day, the opioid epidemic is devastating not only Rhode Island but our entire country.

The death rate from opioids has more than quadrupled since 1999; and the greatest tragedy is that about half of those deaths were caused not by illicit drugs dealt on the streets, but by prescription opioids.

Used for years to treat moderate to severe pain, prescription opioids such as oxycodone, hydrocodone and methadone can provide patients with an effective method of pain management.  However, for some patients, an opioid prescription intended to temporarily treat pain can lead to addiction, financial ruin and even death. Opioid addiction takes a brutal toll on our families, communities and the economy of our state. The negative impact it’s having cannot be overstated. Make no mistake: the opioid crisis is the epidemic of our time.

Research indicates that the majority of addicts first misused prescription opioids. According to the Centers for Disease Control and Prevention, there has been a significant increase in opioid prescriptions for pain since 1999, while the amount of pain that Americans report has not changed much overall.

Opioid use has become a problem that touches each and every one of us one way or another. For state legislators, we’re tasked with finding creative and innovative policies that will curb addiction, or better yet, prevent it from happening.

That’s why I’ve introduced two bills that will zero in on a potential problem from the first prescription. This legislation has been passed by the House of Representatives and is now being considered by the Senate.

The first bill (2018-H 7416) gives the patient the option of only partially filling their prescription for painkillers. It would allow a pharmacist to dispense only part of a prescription for a Schedule II controlled substance at the request of either the patient or the prescriber. The patient would have the option to return to the pharmacy for the rest of the prescription if the patient needs it. One of the striking things we’ve heard about the opioid crisis from the CDC is that almost 80 percent of people who are at the highest risk of overdose initially acquired pills that were legally prescribed to someone — either themselves, a friend of a relative. This legislation empowers patients to limit the number of unused pills that are left in their medicine cabinets, which is where opioid addiction sometimes begins.  

The second bill (2018-H 7496A) would establish a procedure for individuals to voluntarily file a revocable non-opiate directive form with the patient’s licensed health care practitioner. The form would indicate to all practitioners that the patient has chosen not be administered or offered a prescription for an opiate. While a patient may revoke this directive at any time, it is intended to act as a speed bump in the opioid prescription process.

We all need to work from every angle in combating the opioid epidemic. This is not a problem that’s going away on its own. We must resolve to halt this crisis that is bringing tremendous sorrow to our families and communities. I truly believe this legislation--designed to encourage everyone to slow down and think about the dangers of opioids — will go a long way to help right where problems begin, at that first prescription.

The author, Rep. Nicholas A. Mattiello, is the Rhode Island Speaker of the House. He represents District 15 in Cranston. 

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