Warren-Clark bill would permit partial filling for opioids

Printed from: http://newbostonpost.com/2016/02/24/warren-clark-bill-would-permit-partial-filling-for-opioids/

BOSTON — U.S. Sen. Elizabeth Warren and U.S. Rep. Katherine Clark, both Massachusetts Democrats, introduced a bill in Congress on Wednesday that would allow for the partial filling of opioid prescriptions, a strategy being explored by state lawmakers to reduce the number addictive painkillers in circulation.

The legislation would let prescribing physicians or patients request a partial fill of an opioid prescription with remaining portions of the prescription available to patients at a later date.

“Tacking the opioid abuse epidemic will be tough, but we can take an important step by reducing the number of pills in circulation. This bipartisan bill will empower patients and doctors to work together to determine appropriate pain treatment, while limiting the number of unused pills left in family medicine cabinets,” Warren said in a statement.

State lawmakers are currently negotiating legislation that similarly aims to reduce the the number of addictive opioids, or synthetic opiates, in circulation. The Baker administration has said that in 2014 doctors in Massachusetts wrote 4.6 million prescriptions for opioids totaling more than 255 million pills to a population of just over 6.7 million people.

The state Senate last year passed an opioid abuse prevention bill that included a provision pushed by Quincy Sen. John Keenan to allow for the partial filling of opioid prescription, despite concerns that the strategy might run afoul of federal law.

The original bill proposed to allow individuals to take out their prescriptions for schedule II narcotics, which includes drugs like Oxycontin, in smaller batches over time, but still adding up to the total prescription size. That section was ultimately amended in an attempt to comport with federal law to allow a one-time smaller fill at the patient’s request, but would require the patient to go back to their doctor in order to receive the balance of the prescription.

Warren and four other senators, including junior Massachusetts U.S. Sen. Edward Markey, wrote to the U.S. Drug Enforcement Administration seeking either a clarification or a new rule that would expressly allow for the partial filling of Schedule II drug prescriptions, as is already clear for Schedule III, IV and V substances.

The bill filled by Warren and Clark on Tuesday would clear up any regulatory ambiguity by clearly stating that remaining portions of partially filled prescriptions may be filled at a later time, but ‘‘must be exhausted prior to, or on the same date that such prescription, if fully filled, would have been exhausted.”

Gov. Charlie Baker and the House took a different tact toward limiting the quantity of opioids being prescribed. Baker proposed to limit the amount of pills a doctor could prescribe to a first-time patient to a three-day supply, while the House in a bill it passed in January pushed that to seven days.

The House and Senate bills are now before a conference committee, and Baker said Tuesday he’s “optimistic” that a compromise could be struck in the coming weeks before the House turns its attention fully to a debate over the fiscal 2017 budget in April.

“I get the fact that this is complicated and we proposed some pretty disruptive stuff, but I’m more optimistic about this. It’s my sense about this that we’re likely to see something fairly shortly and unless I get told otherwise I’m going to presume that’s going to be the case,” Baker said.

At a meeting with governors from around the U.S., including Baker, President Barack Obama refused to back their calls for limits on synthetic opiates prescribed to reduce pain.

“If we go to doctors right now and say ‘Don’t overprescribe’ without providing some mechanisms for people in these communities to deal with the pain that they have or the issues that they have, then we’re not going to solve the problem, because the pain is real, the mental illness is real,” Obama said, according to the Associated Press. “In some cases, addiction is already there.”

But Markey, in a statement Wednesday, blasted the Food and Drug Administration’s lack of action to address the addiction crisis that the Centers for Disease Control and Prevention says kills 78 Americans every day.

“We will not solve the prescription drug crisis with an FDA that operates with business as usual,” Markey said. “The FDA is supposed to be our nation’s pharmacist, but right now, it is prescribing dangerous and addictive opioid painkillers without limits, without supervision and without consequence.”

U.S. Shelley Moore Capito of West Virginia and U.S. Rep. Steve Stivers of Ohio, both Republicans, co-sponsored the partial-fill legislation.

Written by Matt Murphy

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