Proposed bill focuses on opioid pill prescriptions and accountability

The bill would limit a prescription to a max of seven days worth of pill for a person who hadn't been prescribed opioids in the last 12 months.

Seven days worth of pills. That's that maximum some patients would be able to get at a time under a proposed bill in the state legislature.

It's also asking for more accountability from those authorized to write a prescription.

"We have a problem with opioid abuse and addiction and overdose in our state," said Democratic State Senator Irene Aguilar.

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It's why she's working on a bill that focuses on how many opioid pills can be prescribed for acute pain.

It would limit a prescription to a max of seven days worth of pill for a person who hadn't been prescribed opioids in the last 12 months.

They could sign off on a refill for one more week for acute pain, but they'd have to check a state database tracking opioid prescription sales.

"Double check our database that someone isn't getting narcotics from multiple doctors," said Aguilar.

That's a change because physicians and those authorized to prescribe opioid pills aren't required to do so now.

Some doctors agree focusing on them is okay.

"In the opioid epidemic doctors have played a significant role in creating it. Our prescription practices were far to liberal," said Dr. Don Stader, who said it's been that way for years.

He worked on this legislation and is with the Colorado Medical Society.

That feeds into a critical part of the opioid epidemic: leftover pills.

It's how 71 percent of opioid addictions start across the country and 16 percent start with prescriptions, according to Dr. Rob Valuck, with Colorado's Consortium for Prescription Drug Abuse Prevention.

"The notion of cutting down the initial supply is really good idea," said Dr. Valuck.

But Dr. Valuck said getting doctors to check the database could be tricky.

Dr. Valuck said, "It takes time out of their time with their patient to check this." He says by the time they login into the database, look up the patient and read through the report, in some cases, it can cut into about half of the time during the patient's appointment.

"It's appealing on the one hand to make sure we don't miss anything. It's also asking doctors to do a lot of work to catch a few things when there are limited resources," said Dr. Valuck.

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Dr. Don Stader said it's important it find the right balance.

"We don't want much to get between a physician and patient and that sacred space," he said.

We heard many concerns from people on social media, including questions including if this would affect people with chronic pain.

Sen. Aguilar responded, "The answer to that is no. This is really is for the person who has not be on any opiates at all and has a new prescription for narcotics."

In response to questions about looking into alternative therapies:

Sen. Aguilar spoke about how it's important for both patient and physicians to know that taking non-prescription medications have shown good results.

She also addressed insurance coverage:

"If someone is seen in the emergency room it usually is covered as a part of the visit. There is another bill that will be worked on in the House of Representatives looking at whether we can make sure co-payment for some of the alternative therapies is not cost prohibitive. And perhaps looking at whether we decrease incidents of people becoming addicted or overusing drugs because of making that treatment more readily available."

We also got some questions about how this would affect people living in rural Colorado.

"Many narcotics can be re-filled by an electronic transmission or a phone order. Just by calling their doctor's office the doctor can still do the due diligence required and arrange for an electronic prescription to be sent or just call in to the pharmacy," said Aguilar.

She also said it doesn't require people to make another trip to the doctor. "Just requires certain work from the doctor before the authorize further refills."

Exceptions to the rules also include people determined to have chronic pain, people diagnosed with cancer and those in hospice.

And if a doctor decides a new patient will need more pain medication and/or decides the patient's condition is chronic, the potential new restrictions wouldn't apply.

As for regulations in a situation like that Aguilar said, "It would be within the providers responsibility to do their due diligence hopefully like they do with any patient."

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This bill addresses just one portion of the opioid epidemic.

It's actually one of six bills introduced this week related to this topic that include discussing access to treatment and coverage to help pay for that treatment.

The next meeting regarding this bill is anticipated for February.

Reporter's Note | I want to say thank you to all of you who took time to write about the proposed bill regarding opioid pills, prescriptions and physician accountability. Here is a section of our raw interview with Sen. Aguilar addressing some of your questions.