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The Comprehensive Addiction and Recovery Act 2.0 is set to be proposed to the US Senate this month
It expands harm reduction efforts and SUD treatment!
Unfortunately, one section of the bill concerns me, and likely concerns you too. Even if you don’t know it yet.
A thread.
It expands harm reduction efforts and SUD treatment!
Unfortunately, one section of the bill concerns me, and likely concerns you too. Even if you don’t know it yet.
A thread.
In section 201, the proposed bill contains a federal restriction on all initial opioid prescriptions for acute pain, limiting them to 3 days of use.
That is unless it is an Rx for end of life care, palliative care, cancer pain, or an Rx for SUD treatment.
That is unless it is an Rx for end of life care, palliative care, cancer pain, or an Rx for SUD treatment.
Previous legislation in Ohio and other states that has limited the duration of acute pain opioid Rx’s has included additional exceptions to that limit.
Exceptions such as trauma, surgery, or clinician judgement.
These exceptions however are not included in the CARA 2.0 bill
Exceptions such as trauma, surgery, or clinician judgement.
These exceptions however are not included in the CARA 2.0 bill
This afternoon I attended a WebEx meeting hosted by Senator Portman’s office staff, seeking clarification in regards to the presence of additional exceptions to this 3-day limit.
As of now, additional exceptions are not intended to be included within the bill.
As of now, additional exceptions are not intended to be included within the bill.
It should be noted that many surgical patients are prescribed more medications than they need.
Overprescribing and the resulting leftover meds can be found/taken by family members and has been found to be a driver of early Rx opioid use disorder and lead to illicit opioid use.
Overprescribing and the resulting leftover meds can be found/taken by family members and has been found to be a driver of early Rx opioid use disorder and lead to illicit opioid use.
The 3 day limits intent is specifically to require increased communication between prescribers and pain patients early on and limit this overprescribing.
Despite its intent however, I believe that this limit is too strict, and limits our ability to provide individualized care.
Despite its intent however, I believe that this limit is too strict, and limits our ability to provide individualized care.
The reality is that many patients require more than 3 day opioid prescriptions when they leave the ED or the hospital, and yes that is despite adequate use of non-opioid therapies.
This barrier for patients requiring > 3 days worth likely extends beyond a simple phone follow up.
This barrier for patients requiring > 3 days worth likely extends beyond a simple phone follow up.
I support a lot of the efforts in this bill to expand harm reduction efforts and addiction treatment.
But I believe this limit needs to be addressed and changed as it will negatively impact our pain patients.
We need to support both our SUD patients AND our pain patients.
But I believe this limit needs to be addressed and changed as it will negatively impact our pain patients.
We need to support both our SUD patients AND our pain patients.
Luckily, their office is very polite and has expressed that they are open to hearing more feedback and would consider updates to the bill to better reflect the needs of our pain patients.
If you have constructive comments on improving the bill, I encourage you to speak up.
If you have constructive comments on improving the bill, I encourage you to speak up.
Advocate for our pain patients and amplify this concern should you share it.
Fighting this epidemic is a delicate balancing act, we need to have evidence-based, pragmatic approaches to mitigating this crisis without doing further damage to our vulnerable and suffering pain pts
Fighting this epidemic is a delicate balancing act, we need to have evidence-based, pragmatic approaches to mitigating this crisis without doing further damage to our vulnerable and suffering pain pts
Thank you for reading!
