PHARMACY

NACDS’ Anderson urges drug abuse prevention bill sensitive to chronic pain patients’ needs

BY Sandra Levy

The Hill on Sunday published an opinion piece by National Association of Chain Drug Stores’ president and CEO Steve Anderson that urges enactment of legislation to help reduce opioid addiction and abuse, while maintaining medication access for those in need of the medications for chronic pain, cancer, other diseases, and end-of-life care.

In the opinion piece, Anderson urges support for the John S. McCain Opioid Addiction and Prevention Act (S. 724/H.R. 1614), introduced by Sens. Kirsten Gillibrand, D-N.Y., Cory Gardner, R-Colo., and Reps John Katko, R-N.Y. and Thomas Suozzi, D-N.Y.

The bill would limit to a seven-day supply a first prescription of opioids for temporary, or acute, pain – such as that associated with a broken bone.

The legislation is consistent with the Centers for Disease Control and Prevention’s guidelines for prescribing opioids, which state that, for acute pain, “three days or less will often be sufficient; more than seven days will rarely be needed.” The legislation would not prevent a prescriber from issuing another prescription after the first one to address a patient’s needs.

“The national discussion of opioid-related issues can resemble a pendulum. It swings to a focus on the sincere needs of patients suffering with excruciating chronic pain. It then swings to address the desperate pleas of communities and families who have tragically lost loved ones to drug abuse and addiction,” Anderson wrote.

Anderson continued, “The victims deserve more than a pendulum-approach to policymaking and publicity. They deserve a comprehensive approach to a complex dilemma, that – at the same time – addresses everyone’s needs.”

From that perspective, Anderson described the role of S. 724/H.R. 1614 as part of a far-reaching approach to the issue: “[the bill] essentially would establish a ‘safety’ mechanism for the use of opioids in the management of acute pain.”

While the opinion piece notes that the legislation should not be considered a panacea, but rather part of a comprehensive effort, it also notes the complexities of the current state of drug abuse. Anderson described the substantial impact of illegally made and trafficked fentanyl and heroin.

NACDS emphasizes that the seven-day limit for initial acute-pain opioid prescriptions is consistent with pharmacists’ recommendations from the front-lines of care, their collaboration with law enforcement, and the needs of chronic pain sufferers. Six-in-10 Americans support this measure, with only two-in-10 indicating opposition, according to a January 2019 Morning Consult poll commissioned by NACDS.

NACDS noted that the opinion research reflects consistent support for this strategic approach across political ideologies, and that support is particularly strong among seniors. Further, seven-in-10 voters support “advancing policies that leverage pharmacies’ role as working partners for stronger and safer communities – such as working to address the opioid-abuse epidemic.”

The bill is consistent with one of NACDS’ priority public policy recommendations to help further address the opioid abuse epidemic. NACDS’ recommendations relate to initial-prescription limits for acute pain; prescription drug monitoring plans; drug disposal; and mandatory electronic prescribing.

The legislation would build on the SUPPORT for Patients and Communities Act (H.R. 6), enacted in 2018, which is consistent with all of NACDS’ recommendations and which was particularly helpful in requiring electronic prescribing for Schedule II through V controlled substances prescriptions covered under Medicare Part D to help prevent fraud, abuse and waste – with limited exceptions to ensure patient access.

The legislation also is consistent with the White House’s 2019 National Drug Control Strategy, which NACDS welcomed in February.

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