Legislation Comparison
Bill Name
John S. McCain Opioid Addiction Prevention Act.
Bill Number: S. 724/H.R. 1614.
Description
The Senate bill sponsored by U.S. Representatives Thomas R. Suozzi and John Katko aims to decrease the prescribed drug supply to mitigate the ongoing opioid epidemic. In general, it is an amendment to the Controlled Substances Act that would add specific registration requirements for practitioners that prescribe medicines containing opioids. In the case of acute or temporary pain caused by injury, patients initially would be able to use opioids for no more than seven days (NACDS.org Staff, 2019). The Act would only limit the first opioid prescription concerning acute pain management. The bill does not influence the treatment of patients’ chronic pain. It also does not apply to end-of-life cases, alternative pain-management therapies, and individuals who have cancer.
Legislative Intent
Since health care professionals play the most crucial role in the crisis, the new regulation’s requirements allegedly eliminate the oversupply of prescription analgesics combating misuse and addiction threats. It also meets the Centers for Disease Control and Prevention (CDC) guideline to apply opioid pain killers in pain management for less than seven days.
Proponents
Senator Kirsten Gillibrand, in response to the bill’s critics, explained the initiative in her blog post. She highlighted that the proposed legislation would not cover the seven-day limit for end-of-life, cancer, and palliative care prescription of opioids. Doctors and other prescribers would also reserve their right to continue opioid treatment. Gillibrand (2019) added: “I fundamentally believe that all health care should be between doctors and patients, and this bill is not intended to interfere with these decisions but to ensure doctors prescribe opioids with a higher level of scrutiny, given their highly addictive and dangerous effects.”
Steven C. Anderson, the President and Chief Executive Officer of the National Association of Chain Drug Stores (NACDS), backed the legislation enactment believing in its potential to reduce opioid abuse and addiction. In his opinion piece, Anderson (2019) described the role of the legislation as the safety mechanism that would help manage the use of opioids. However, he insisted on unlimited access to opioid prescriptions regarding end-of-life care, cancer, and chronic pain.
Opponents
Pharmaceutical companies that supply opioid drugs are the primary opponents in such cases. They usually play an ambivalent game by supporting drug control improvement and cautious prescription and simultaneously spending millions on lobbyists who combat measures and initiatives to limit the volume of drug prescriptions. For instance, the American Cancer Society Cancer Action Network worked against the bill introduced by Rep. Ryan Williams to decrease the number of drug-addicted babies resulted from a 2001’s law enacted in Tennessee (Whyte et al., 2016). These lobbyists criticized the measure as they did not want to see cancer patients unable to ease their chronic pain, although the bill was not designed to cover such limits initially. Such groups usually receive significant funding from drug makers that help the latter to influence their lobbying activity.
Target Population
The target population is American people and drug prescribers. The bill is primarily designed to decrease the possibility of addiction for every person facing pain caused by severe injuries. It also would challenge the current prescription practice of clinicians.
Status of the bill
- 03/07/2019 Introduced in House
- 03/07/2019 Referred to the Committee on Energy and Commerce, and in addition to the Committee on the Judiciary.
- 03/08/2019 Referred to the Subcommittee on Health.
- 04/12/2019 Referred to the Subcommittee on Crime, Terrorism, and Homeland Security.
General Notes/Comments
Under the new regulations, clinicians would have to certify that they would not treat their patients with Schedule II, III, or IV opioid analgesics for longer than seven days of supply.
Testimony Statement
I am here to support the bill S. 724/H.R. 1614, also known as John S. McCain Opioid Addiction Prevention Act. Misuse of prescription opioids led to drug abuse among 80% of people who use heroin for non-medical purposes (NACDS.org Staff, 2019). The volume of opioid analgesics prescribed to patients with chronic and acute pain increases every year, fuelling the ongoing opioid crisis. Overprescribing often leads to patients’ addiction and overdose deaths caused by prescription-type medicines. This legislation would require doctors to certify no longer than seven day supply of opioid analgesics, ensuring that American people would not get addicted following the treatment of pain caused by various injuries.
The current drug issue was caused both by insufficient legislation and drug manufactures’ interference. Many doctors were found by a CNN-led investigation receiving money from pharmaceutical companies for prescribing powerful painkillers (Kessler at al., 2018). Ill-minded manufacturers have intensified overprescribing by paying more money to hundreds of physicians supposedly for consulting, speaking, and promoting their painkillers. The more prescriptions were written, the more significant transaction they received. Even taking into consideration, that majority of clinicians are honest professionals, more control in pain-management would contribute to the needed decrease in overall opioid use. If this proposal were to be enacted as a law, drug prescribers would feel obliged to reduce opioid drug treatment of acute pain as much as possible.
In terms of acute pain, the CDC issued a guideline for prescribing opioids. It recommends that “three days or less will often be sufficient; more than seven days will rarely be needed” (Anderson, 2019). Every additional day of use increases the chance of a patient’s addiction. Despite the fears and concerns stressed by opponents, the legislature does not apply to opioid treatment of chronic pain. Those who have cancer would not struggle to receive proper treatment. Moreover, doctors would be able to prescribe opioids one more time following the initial treatment period if there is a reasonable need.
Comprehensive control of opioid painkillers prescription for non-chronic pain and addressing the growing overprescribing must be a top priority. Every patient and his/her loved ones should have confidence in physicians’ decisions to prescribe opioids for the first and consecutive times. Such choices must proceed from evidence-based practices rather than financial self-interest. This legislation would also promote alternative pain relief methods that are less dangerous and more effective in the long-run.
In conclusion, I want to draw your attention to one particular trend. In 2016 every day claimed about 116 Americans due to illicit or prescription opioids misuse, whereas in 2018, this figure already reached 128 lives per day (Compton et al., 2018). The overprescribing practice would continue to fuel the current crisis if related initiatives would not enter into force. This legislation is not a panacea for drug abuse and addiction, but it is an essential element of the comprehensive effort. I want to thank you for your attention. We must join hands in fighting the unreasonable use of opioid medicines, starting with the change to the Controlled Substances Act.
References
Anderson, S. (2019). There’s a pain bill that’s actually sensitive to patients — let’s pass it.The Hill. Web.
Compton, W. M., Jones, C. M., Stein, J. B., & Wargo, E. M. (2019). Promising roles for pharmacists in addressing the U.S. opioid crisis.Research in Social and Administrative Pharmacy, 15(8), 910-916. Web.
Gillibrand, K. (2019).I hear you — and I want to get my bill on opioids right.Medium. Web.
Kessler, A., Cohen, E., & Grise, K. (2018). CNN Exclusive: The more opioids doctors prescribe, the more money they make.CNN. Web.
NACDS.org Staff. (2019). John S. McCain Opioid Addiction Prevention Act gains broad support.NACDS. Web.
Whyte, L. E., Mulvihill, G., & Wieder, B. (2016). Politics of pain: Drugmakers fought state opioid limits amid crisis.The Center for Public Integrity. Web.