AUGUSTA — Similar to an infectious disease epidemic, heroin addiction seems to be spreading like wildfire in Maine. Nearly every week, another Mainer dies from a heroin overdose.

Thousands of Maine citizens addicted to this deadly opiate are hurtling down a destructive path toward HIV and hepatitis C infections, permanent changes to their brains and devastating consequences for their personal lives.

As in an infectious disease epidemic, we must provide access to effective and appropriate treatment for those afflicted. Also, we must try to prevent others from becoming affected. Gov. LePage has proposed one potentially bold solution to prevent more lives from being cut short and families being left broken.

Research indicates that more than three-quarters of all heroin addicts become addicted through the gateway of a legally prescribed opioid painkiller. In 2014, 350,000 Mainers were legally prescribed 80 million opioid pills, the equivalent of one-third of our adult population taking a highly addictive opioid pill every day for seven months.

I recently saw a pharmaceutical commercial from 1998, extolling the merits of OxyContin (a commonly prescribed opioid painkiller). The spokesman said soothingly to viewers: “Don’t be afraid to take what (prescribers) give you for pain. Often it will be an opioid medication. Some patients may be afraid of taking opioids because they’re perceived as too strong or addictive, but that’s far from actual fact.”

Clearly, health care providers were lulled into complacency by pharmaceutical companies in the 1990s. For the past 20 years, the health care industry has flooded our communities with opioid painkillers. We now see the devastating effects; it is clearly time for a course correction.

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Gov. LePage’s bill delivers a strong antidote. It will require prescribers to view the Prescription Monitoring Program database before prescribing opioids or benzodiazepines (tranquilizers such as Xanax or Valium) for their patients.

The Prescription Monitoring Program is a repository for all controlled prescriptions written in the state; it allows prescribers to ensure that their patient has not been to other prescribers or pharmacies seeking similar medications. Currently, participation in the Prescription Monitoring Program is voluntary, and sadly, fewer than one-third of prescribers use it.

The bill will also place reasonable limits on opioid prescriptions at 100 morphine milligram equivalents per day and holding prescriptions to no more than 15 days for chronic pain and three days for acute pain without a refill. Beginning in 2018, it will require prescribers to receive training on the risks associated with opioid drugs every five years and require opioid prescriptions to be sent to pharmacies electronically in order to prevent potential diversion.

MaineCare – the state’s Medicaid program – implemented similar prescribing limits and has seen opioid prescriptions drastically decline since 2012. It’s time that we replicate MaineCare’s success across our state’s health care system.

Gov. LePage was especially moved and motivated to introduce this legislation after he met with a constituent, a young widow. She shared her story, one we hear more often than we would like. Her husband was injured at work and prescribed opioid painkillers for a prolonged period of time. This began his tragic, downward spiral into a heroin addiction that ultimately took his life.

Too many Mainers are following the same road toward addiction and self-destruction. We need to act.

This is a prevention bill designed to address one part of the problem: protecting Mainers from the risks of addiction through safe and appropriate use of these potentially harmful prescription drugs. It is about educating patients and increasing accountability in prescribing potentially highly addictive medications. While not a panacea for this complex public health crisis, it should be seen as a powerful tool in addressing the source of potential future opioid addiction and is similar to regulations in 27 other states. Another, similar bill before the Legislature will ask the medical community to consider some level of self-regulation by mid- to late 2017. That’s too late. We need strong, enforceable changes now.

If you or someone you know has been affected by opioid or heroin addiction, please consider calling or emailing your state legislators and urging them to support Gov. LePage’s bill to strengthen the Prescription Monitoring Program and limit opiate and benzodiazepine prescribing. Together, we can break the cycle of heroin addiction and right the wrongs of past prescribing practices.

 


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