According to an announcement from the Trump administration, the government’s employee health plan will strengthen its rules for covering prescription opioids.  The Federal Employee Health Benefits Program is the world’s largest health plan, covering an estimated 9 million people, including federal workers, retirees, and their family members.  The new policy will prevent opioid overprescribing by placing restrictions on short-term pain relief while continuing to ensure those with cancer and other chronic conditions have access to their prescriptions.Under the administration’s new restrictions, the initial prescription for opioids will be for a seven-day supply, instead of up to a month.  Patients will be able get up to three refills of seven days each.  After 28 days of refilling, formal re-authorization by a clinical professional is required.  Several states have also instituted similar practices and the administration said it will be following their lead.  In 2016, Massachusetts became the first state to pass a law limiting one-time opioid prescriptions to just seven days, and since then, over half of all U.S. state have passed measures restricting the prescribing or dispensing of opioids.

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In the midst of the epidemic, major flaws with past prescribing practices have been brought to light, including overprescribing when medically unnecessary and unused pills making their way to the streets and being sold illegally by dealers.  As a silver lining, The Centers for Disease Control and Prevention (CDC) recently announced that overdose deaths appear to have declined last year for the first time in nearly three decades, showing that changes that are being made are working.  Many believe, however, more still needs to be done.The decrease in fatalities was primarily due to a drop in the number of deaths from heroin and prescription opioid painkillers, the CDC reported.  It warned that deaths involving fentanyl are still on the rise, and that this deadly drug continues to be mixed into many street drugs.In February, The Pharmacy Times reported, “To date, there is no data on whether and to what extent these laws mediate opioid-related morbidity and mortality, as well as whether they are associated with negative unintended outcomes.  In the absence of more evidence, it is premature to rely on prescription limitation laws to make the type of impact on the opioid epidemic that is desperately needed to save lives.”Many believe that the new restrictions are too rigid for patients who really need pain relief and they fear the laws will prevent those who already face significant barriers from receiving proper treatment.Thaddeus Mason Pope, JD, PhD, Director of the Health Law Institute and Professor of Law at the Mitchell Hamline School of Law in Saint Paul, Minnesota, stated, “Several medical societies [and] commentators have called on lawmakers to recalibrate the balance between reducing misuse while still enabling appropriate access…Prescription limit laws are well intended, [but] without clear exemptions for patients with cancer and cancer survivors, these laws sweep too broadly and unnecessarily constrain legitimate pain management.”Mark Rosenberg, a spokesperson for the American College of Emergency Physicians, said pain management is still largely an unregulated practice. “Until recently, it was very subjective,” he said. “Standardizing pain management will go a long way in decreasing variability in treatment.”

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Trump administration to reduce length of opioid prescriptions for federal employeesOpioid Prescribing Limits Across the StatesPain Management Standardization is Needed, Some Experts Say