A bill to establish strict prescribing rules for opioids was endorsed Wednesday by the Legislature’s Health and Human Services Committee, which made some minor changes to the bill.

The bill will be considered on the floor of the House and Senate in the coming weeks. The prescribing standards were introduced by the LePage administration, so the governor is likely to sign the bill if it clears the Legislature. Maine will have one of the strictest prescribing rules in the country if the bill is approved, according to a national expert.

The bill, which aims to curb the flow of prescription opioids that are contributing to the state’s heroin epidemic, will set a dosage cap of 100 morphine milligram equivalents, limit prescriptions to 30 days for chronic pain and seven days for acute pain, require use of the state’s Prescription Monitoring Program and mandate training for doctors before they prescribe opioids.

Four out of five new heroin users are first addicted to prescription painkillers, according to the American Society of Addiction Medicine. Maine’s heroin crisis has worsened in recent years, and 272 people died in the state from drug overdoses in 2015, an all-time high.

Among the changes the committee endorsed in an 11-1 vote Wednesday was permitting a lengthy tapering for those with existing opioid prescriptions. For those patients, doctors could prescribe as much as 300 morphine milligram equivalents. Doctors would be expected to taper their patients to 100 morphine milligram equivalents by July 2017.

The committee also endorsed exceptions to the dosing rules for cancer patients, hospice, palliative care, nursing homes, in-hospital patients and possibly other conditions identified by the Maine Department of Health and Human Services.

Gordon Smith, executive vice president of the Maine Medical Association, an advocacy group for physicians, said the bill is a “unique solution for a unique problem.”

“These will still be among the most stringent limits in the country,” Smith said.


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