House Passes Bill Limiting Some Opioid Prescriptions

The House on Monday approved a measure limiting opioid prescriptions for first-time and temporary uses, passing a critical portion of Gov. Bill Haslam’s agenda to combat the opioid crisis in Tennessee.

The measure, sponsored by Senate Majority Leader Mark Norris, R-Collierville, and Rep. David Hawk, R-Greeneville, adds limits to prescriptions for new patients referred to as “the opioid naive,” but does not cut prescriptions for current or patients in chronic pain.

The measure passed 94-1.

“This is a major piece of legislation in our fight against the epidemic,” said Rep. Sabi Kumar, R-Springfield, who is also surgeon.

Haslam outlined a $30 million effort earlier this year to combat the opioid crisis in the state.

Early on, doctors and organizations like the Tennessee Medical Association criticized portions of the governor’s plan, known as TN Together, over concerns it limits a physician’s discretion on when to prescribe opioids to patients in need.

But the Haslam administration, lawmakers and health care providers later reached a compromise on the measure.

The compromise moved the proposed legislation away from a strict, five-day limit to a policy that gives doctors more leeway — including the ability to prescribe up to a 10-day supply in some cases.

“We believe this compromise addresses concerns while still limiting the supply of opioids for opioid naïve patients and placing more checkpoints between healthcare practitioners and patients to prevent more Tennesseans from misusing or abusing prescription pain medicine,” Haslam spokeswoman Jennifer Donnals said in a previous statement on the bill.

Although law enforcement and treatment play a role in the governor’s plan to combat the state’s opioid crisis, a key focus has been prescription limits to patients deemed “opioid naïve.”

The hope is to shut off the flow of new Tennesseans becoming addicted to the drugs.

The Tennessee Department of Health and the Department of Mental Health and Substance Abuse Services have pointed to studies showing that patients who receive opioid prescriptions exceeding five days face a higher risk of addiction.

Similarly, the departments have said the 7 million opioid prescriptions filled annually in Tennessee are indicative of a problem of over prescription.

What are the proposed new limits?

In the amended version of bill, prescribers may offer patients a three-, five- or 10-day prescription with no more than a 10-day supply and with a dosage that does not exceed a total of 500 morphine milligram equivalent dose.

The bill also includes some other exceptions for serious ailments, such as a “more than minimally invasive procedure” or where the risk of intense pain exceed the risk of addiction.

The updated legislation also says doctors must enter information into a state database of opioid prescriptions for “a new episode of treatment.”

The bill has been referred to the Calendar Committee in the Senate.

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