Oregon lawmakers try to stem opioid epidemic

SALEM, Ore. — Seeking to stem the opioid epidemic in Oregon and prevent overdose deaths, the House of Representatives unanimously approved a proposed law on Monday that would provide safe-use recommendations to those who prescribe such pain-killing drugs.

However, provisions in the bill that would have limited health-care practitioners to prescribing a maximum seven-day supply and would have criminalized improperly prescribing opioids were earlier stripped by the House Health Care Committee. The Oregon Medical Association had lobbied against some of the provisions.

The state attorney general's office had strongly backed the measure because "the risk of overdose and addiction is serious."

"In 2014, enough opioids were prescribed in Oregon for nearly every person in the state to have a bottle," Assistant Attorney General David Hart said in written testimony.

More than 15,000 people died in America from overdoses involving prescription opioids in 2015, according to the U.S. Centers for Disease Control and Prevention. In Oregon, more drug poisoning deaths involve prescription opioids than any other type of drug. The Oregon Health Authority says an average of three Oregonians die every week from prescription opioid overdose.

The original bill, sponsored by Rep. Mitch Greenlick, D-Portland, and House Majority Leader Jennifer Williamson, D-Portland, would have limited prescriptions to seven days, unless a health-care practitioner determined more was needed for an acute medical condition or for various types of pain, like that associated with cancer. It also would have made it a crime to refuse to furnish records or to prevent inspections.

In a Feb. 28 memo to the health care committee, Oregon Medical Association general counsel Mark Bonanno said: "We do not believe criminalizing prescription writing achieves better patient care. In fact, if practitioners fear prosecution for writing prescriptions for opioids or opiates, we expect the pendulum for the public health issue of properly treating pain will swing all the way back to under-treatment of pain."

Under the amended bill, the Oregon Medical Board, the Oregon State Board of Nursing and the Oregon Board of Dentistry would provide notice to practitioners they regulate of recommendations for safe use of opioids.

Among the guidance contained in Oregon Opioid Prescribing Guidelines: Recommendations for the Safe Use of Opioid Medications:

  • Consider opioid therapy only if expected benefits for both pain and function are anticipated to outweigh risks
  • Prescribe the lowest effective dosage
  • If clinicians suspect their patient might be sharing or selling opioids or intentionally misusing them, clinicians should consider urine testing to consider whether opioids can be discontinued abruptly or tapered
  • Clinicians should avoid prescribing opioids and benzodiazepines (a class of psychoactive drugs).

Now that it has passed the House, the bill next goes to the Oregon Senate.

This story has been corrected to show that no seven-day supply limit is imposed via the bill.

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