Florida is in the throes of an epidemic of opioid abuse and addiction. Individuals, families, communities, health providers, employers and taxpayers are all paying a heavy price. For state legislators, in the midst of their annual 60-day session, there is no defensible excuse for inaction.
Deaths related to opioids — heroin and related painkillers — spiked to 5,300 statewide in 2016, a 36 percent jump from the year before. Final numbers aren’t in yet for 2017, but they are expected to be even higher.
The damage reaches every part of society. A University of South Florida study tied a surge in parental neglect cases in the state to opioid abuse, and pegged the additional cost for taxpayers of foster care at $40 million. The annual tab for treatment attributable to the epidemic at hospitals in Florida more than doubled between 2010 and 2015 from $460 million to $1.1 billion.
In his State of the State address opening the legislative session, Gov. Rick Scott touted his budget request to spend $53 million more next year in state and federal dollars to fight opioid abuse. Considering the scale and cost of the epidemic, legislators should consider this total — a rounding error in the governor’s $87 billion budget proposal — to be their starting point for additional funding.
Scott also appealed for legislators to approve steps “to prevent drug addiction on the front end.” Bills backed by the governor in the House and Senate would help accomplish this essential goal by imposing limits and other reasonable requirements on doctors prescribing opioids.
They include a bill introduced by Rep. Jim Boyd, R-Bradenton, to place limits on the supply of drugs a doctor can prescribe a patient dealing with short-term pain to three days. HB 21 also would require all health care professionals that prescribe medication to participate in the Florida Prescription Drug Monitoring Program, which is a statewide database that monitors controlled substance prescriptions.
Scores of lobbyists for health providers and drug companies have lined up to oppose the bills. But the provisions in them are based on guidelines established by the federal Centers for Disease Control and Prevention, and other states have successfully implemented similar steps. It’s crucial for legislators in Tallahassee to stand up to the lobbying pressure and catch up with their counterparts in other capitals.
The centerpiece of the bills would limit initial opioid prescriptions for patients with short-term, acute pain — such as the pain that follows surgery — to three days, but allow up to a seven-day supply if the doctor determines the extended period is medically necessary. The CDC has found that “three days or less is often sufficient and that more than seven days will rarely be needed,” according to legislative analysts.
A policy of limiting the supply of opioids for patients makes them less vulnerable to becoming addicted, and turning to more dangerous illegal drugs like heroin if their supplies run out. The CDC found patients treated for acute pain with a one-day opioid prescription have a 6 percent chance of being on the drug a year later; patients given a 12-day supply have a 24 percent chance.
Some doctors have complained to legislators that their patients need more than seven days worth or painkillers after major surgery, and — because prescription renewals for opioids can’t be phoned in to pharmacies — it would be unreasonable to expect them to return to their doctors for refills. Yet at least a dozen states have set limits of seven days or fewer for opioids.
Another part of the House and Senate bills would require doctors to utilize the state’s prescription-drug-monitoring database when prescribing opioids to make sure their patients haven’t been “doctor shopping” to stockpile painkillers. Florida doesn’t impose this requirement now, but at least nine other states do.
Another measure in the bills would allow the Florida Department of Health to exchange information in the database with other states to prevent doctor shopping across state lines. At least 40 other states share this kind of information.
As Scott told legislators, Florida’s “fight against drugs is not over.” There’s much more for legislators to do.
A version of this editorial first appeared in the Orlando Sentinel.