PAIN MEDS: Rules of Engagement

As the number of prescription opioids sold nation-wide more than tripled over the past decade, drug misuse, abuse, and overdose has continued to be a growing problem in the United States2,5. Misuse and abuse can lead to problems like dependence and addiction. Meanwhile, overdose often leads to troubling side effects such as heavy breathing, unconsciousness, and even death. It is estimated that about 2/3 of all drug deaths are related to prescription opioid medications5.

To face this issue, Louisiana’s government revised prescribing laws for opioid medications. Prescribers must now consider a patient’s medication history in addition to his or her level of pain1. Pain levels can be tricky to pinpoint since varies person to person. Some people are more sensitive than others. While some people naturally have a higher tolerance. However for most people, pain level can usually be placed into one of two categories, acute or chronic. Acute pain tends to be shorter term, while chronic pain may last anywhere from months to years.

No more than 7-days’ worth of pain medication can be written for adults outside of the hospital for acute conditions. Exceptions can be made if an adult patient has been treated for that condition in the past. Children or teens less than 18 may not be prescribed more than 7-days’ worth of pain medications in any medical setting (i.e. hospital, clinic, etc.). However, there are situations in which the 7-day supply rule does not apply. This includes treatment of opioid addiction, chronic pain, cancer pain, and pain from serious illness. In special cases where a prescriber believes that a 7-day supply will be little for proper treatment, they may write for more1.

Louisiana state-funded insurances like Medicaid have begun to limit the amount of opioid pain medication it will cover at a time. For most acute pain medications, LA Medicaid will pay for a total quantity of 28 tablets/7 days4. This allows patients to be treated a short period of time for severe pain, but with less opportunity for medication dependence.

Remember, we all have a role in keeping our communities safe! All drugs, no matter what they are, should be safely disposed of once no longer needed. Before throwing in the trash, make disposed medications less desirable by mixing with products, and sealing mixture in a bag or container3.

For more information on safe disposal practices, contact your local DEA division: https://www.dea.gov/about/Domesticoffices.shtml

References

Broussard, MJ. (2017, July 15). New Laws from 2017 Legislature Affecting Pharmacy Practice, No. 17-01. Louisiana Board of Pharmacy. Retrieved from http://www.pharmacy.la.gov/assets/docs/Bulletins/Bulletin_17-01.pdf
Gostin, L. O., Hodge, J. J., & Noe, S. A. (2017). Reframing the Opioid Epidemic as a National Emergency. Jama, 318(16), 1539-1540. doi:10.1001/jama.2017.13358
Klein, M. (2010, July 28). Combating Misuse and Abuse of Prescription Drugs: Q&A with Michael Klein, Ph.D. [Interview Transcript]. Retrieved from https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm220112.htm
Steele, J. (2017, July 3). Louisiana Fee for Service (FFS) Medicaid Short-acting Opioid 7-day Quantity Limit and MME per Day Limit. Louisiana Department of Health. Retrieved from http://www.lamedicaid.com/provweb1/pharmacy/SA_7_Day_Opioid_Qty_Lt_and_MME_Lt%20Policy_Lt_7-10-17.pdf
(2017, Aug 30). Understanding the Epidemic. Retrieved from https://www.cdc.gov/drugoverdose/epidemic/index.html