Arizona Opioid Epidemic Act Reduces Painkiller Prescriptions’ Potency
The opioid epidemic is a major issue across the United States, but it has hit Arizona especially hard. Health officials announced that more than two people died every day from opioid overdose in Arizona in 2016. In 2017, Governor Doug Ducey declared a public health emergency over the opioid crisis, and the state government has spent the last year searching for a solution.
In Ducey’s State of the State address in January 2018, he pledged to hold “all bad actors” accountable. Later that month, he signed into law the Arizona Opioid Epidemic Act.
The Arizona Department of Health Services issued the Opioid Action Plan in September 2017, which was the result of about 50 meetings over the course of several months. The plan intended to promote safe prescribing, improve treatment access, and reduce drug abuse. Many of the proposals in the 2018 Opioid Epidemic Act are based on the recommendations in the Opioid Action Plan.
The goal of the act is to fight the opioid epidemic by expanding treatment options, stopping overdoses and preventing addiction. Some of the policies call for more money to be invested into treatment programs, some suggest expanding access to Narcan for overdose reversal, and some require doctors to limit their prescribing of opioid drugs.
The Opioid Epidemic Act passed unanimously, and many state politicians were vocal about their support for the law. Senate President Steve Yarbrough said, “This merits our undivided attention to ensure that we pass a comprehensive package that curtails out-of-control prescribing activity and gives focus to treatment and prevention.”
Senate Minority Leader Katie Hobbs said, “We’re pleased that Governor Ducey incorporated many of our ideas into this legislation, especially the commitment of real dollars to provide treatment for those who are opioid addicted but don’t quality for AHCCCS or private insurance.”
Since the Arizona Opioid Epidemic Act was passed, more people are getting treatment for addiction. April 2018 saw a 33 percent decrease in the number of opioid prescriptions compared to April 2017, and there has been a 40 percent increase in referrals for behavioral health treatment for patients who have overdosed.
When Ducey first introduced the act, the Arizona Medical Association and the Arizona Osteopathic Medical Association both expressed concern that the law would interfere too much with clinical practice.
In a letter to the director of the Department of Health Services, both associations gave a reminder that all patients have different care needs and that it’s difficult to pass legislation that considers every individual’s unique situation. They also recommended against setting a dose-strength limit and a five-day limit on first fills.
In response to the letter, Governor Ducey’s administration assured the associations that those who need opioids for chronic pain would still have access to their medications. The restrictions in the Opioid Epidemic Act would apply to new patients only.
While the act passed unanimously in the Arizona state government, doctors have mixed feelings. Some physicians support the new law as it helps them confront patients who they believe are at risk of addiction or overdose. Other doctors worry that the new limitations on prescription opioids will push some patients to try stronger illicit drugs.
Since the act was passed, doctors in Arizona have reported they feel pressured to reduce their patients’ opioid doses. Prescribing doctors receive report cards that compare them to their fellow medical professionals, and they consider these reports when managing their patients’ care. To avoid suspicion or investigation, many doctors feel pressured to prescribe fewer opioids than their peers.
Most of the patients impacted by the Opioid Epidemic Act are those who have been newly prescribed opioids. The act encourages doctors to consider other treatment methods before prescribing opioids, and it sets dosage limits to prevent addiction and overdose. However, some people who have relied on opioids for years to treat their severe pain have been impacted.
Opioids are often the best treatment option for debilitating pain conditions. Patients may have tried dozens of other treatments, but opioids are the only medications that actually improve their quality of life. Although the Opioid Epidemic Act doesn’t explicitly state that doctors should lower their patients’ current doses, their doctors may feel pressured to cut back. A few Arizona residents have reported that their doctors have reduced their doses in response to the new law despite the fact that they’d been on the same dose for years with no problems.
Commitment to Find a Solution
Governor Ducey and the Arizona state government are committed to fixing the opioid problem. Legislators are confident that the Arizona Opioid Epidemic Act will prevent addiction and help more people access treatment. All new laws have their pros and cons, though, and some doctors and patients do seem to be negatively impacted by the act. As legislators continue to address the opioid epidemic, new laws will hopefully find the middle ground.
- U.S. Department of Health and Human Services: https://www.hhs.gov/opioids/about-the-epidemic/index.html
- Centers for Disease Control and Prevention: https://www.cdc.gov/drugoverdose/epidemic/index.html
- Arizona Governor: https://azgovernor.gov/sites/default/files/related-docs/chronicpainweb_0.pdf
- Arizona Department of Health Services: https://www.azdhs.gov/prevention/womens-childrens-health/injury-prevention/opioid-prevention/index.php
- Office of the Governor Doug Ducey: https://azgovernor.gov/governor/news/2019/08/arizona-making-progress-fight-against-opioid-epidemic
- Centers for Disease Control and Prevention: https://www.cdc.gov/drugoverdose/prescribing/guideline.html
- WebMD: https://www.webmd.com/mental-health/addiction/drug-overdose#1
- Johns Hopkins Medicine: https://www.hopkinsmedicine.org/opioids/what-are-opioids.html
- The University of Arizona: https://crh.arizona.edu/news/1833
- Medical News Today: https://www.medicalnewstoday.com/articles/323465