Arizona officials want tougher controls on opioid prescriptions

PHOENIX – Arizona officials on Wednesday said they want to limit doctors to prescribing no more than five days’ worth of opioids for people who haven’t already been on the powerful pain medication.

The proposal is part of the governor’s plan to combat opioid abuse in the state. Gov. Doug Ducey had asked the Arizona Department of Health Services to develop suggestions to reduce opioid deaths in the state.

“That’s been a passion of the governor’s for the last several years,” Director Dr. Cara Christ said Wednesday. “And when we identified in June that Arizona was at its highest number of opioid-caused deaths since we’ve been monitoring, that’s why he called the emergency so that we could identify strategies to keep people from dying.”

The department developed 12 suggestions it hopes to get through the state Legislature.

Dr. Ravi Chandiramani of Blue Door Therapeutics in Scottsdale called the five-day limit a “common-sense approach” because it specifically targets “opioid naive” patients.

“Even a one-day opioid prescription carries a risk of using opioids one year later,” he said.

He said that perhaps in non-emergency settings, it will become more likely for doctors to try non-opioid pain relief methods, such as medical marijuana and less addictive solutions.

The health department also suggested that the state require doctors to submit e-prescriptions instead of paper ones for some controlled substances. This would decrease the likelihood of fraudulent prescriptions and speed up the process for consumers and providers, Christ said.

The department also suggested a requirement for pharmacists to make sure patients aren’t prescribed both an opioid and a benzodiazepine, which could increase the risk of overdose when mixed.

The department’s goals include limiting access to drugs, improving prescription practices and providing better access to treatment for those who are addicted, Christ said. She said the action plan also wanted to target “bad actors” – doctors who illegally prescribe or over-prescribe medicines.

In June, Ducey declared of a statewide emergency after a state study showed 790 opioid-related deaths for Arizona in 2016.

The governor already had taken action on prescription limits. In October, Ducey signed an executive order to limit refills to seven days’ worth of opioid drugs.

The limit included both initial and subsequent prescriptions for children. However, the limit excludes opiate prescriptions for children with “cancer, chronic disease and traumatic injury,” according to a news release from the Governor’s Office. And it only applied to state employees and those in the Arizona Health Care Cost Containment System, the state’s Medicaid program, which covers about 1.9 million individuals and families in Arizona.

The announcement met with some criticism. Cristopher Pitcher, who identified himself as a manager at Haggen Food & Pharmacy in Prescott, said the order would increase costs and hurt those who need the prescriptions, according to a comment to a Cronkite News article.

“It’s now a way of punishing everyone for the ones that chose to abuse them,” he wrote.

Overdoses from opioid drugs have been linked to more than half of drug-related deaths as of 2015, according to the National Institute on Drug Abuse.