In response to the opioid epidemic, state lawmakers plan to introduce legislation that would limit how much pain medicine doctors can prescribe in West Virginia.
Prescription painkillers like OxyContin and Lortab would be limited to a seven-day supply for short-term pain, under the bill.
House of Delegates and Senate leaders are backing the proposed legislation, and lawmakers voted to accept a draft of the bill during an interim health committee meeting Monday. The West Virginia State Medical Association, which represents physicians, also supports the seven-day pain pill limit. The 60-day legislative session starts Wednesday.
“We need this bill,” said Delegate Matt Rohrbach, R-Cabell, a Huntington doctor. “I’m ashamed to say, there are some in my profession that are less than ethical. We need to put some teeth behind the enforcement, to go out and try to get a handle on this problem.”
The new limits would not apply to patients being treated for cancer, and those in nursing homes and hospice care.
If the bill passes, West Virginia would join about two-dozen other states that have set limits on opioid prescriptions for acute pain, such as that caused by a tooth extraction or ankle sprain.
Last year, Kentucky lawmakers passed a law that restricts prescription painkillers to a three-day supply. Pennsylvania has a five-day limit. Other states have directed medical licensing boards to develop tighter rules for opioid prescribing.
The restrictions aim to stop creating new addictions and keep extra pills from entering the illegal drug market.
West Virginia has the highest drug overdose death rate in the nation — and the death toll is climbing.
While illegal opioids like fentanyl and heroin are now causing most fatal overdoses in the state, 65 percent of those who died had a prescription for a controlled substance, typically an opioid, within the previous year. About 40 percent had such prescriptions 30 days before they fatally overdosed.
West Virginia’s bill — called the Opioid Reduction Act of 2018 — also would impose a three-day opioid prescribing limit on dentists, optometrists and medical professionals who work in hospital emergency rooms.
Other sections of the bill would:
Require doctors to counsel new patients, who pick up a second prescription for opioids, about the risks of taking painkillers. After the third prescription, doctors must refer those new patients to licensed pain clinics.
Allow the state medical licensing board to query West Virginia’s Controlled Substance Monitoring Database, which tracks prescriptions.
Require doctors to refer chronic-pain patients to alternative treatments, such as massage and acupuncture, before prescribing opioids. Health insurance companies would have to cover alternative treatment for up to 180 days.
Make gabapentin — a nerve pain drug sold under the brand name Neurontin — a controlled substance that must be monitored. Gabapentin-related overdose deaths have increased in recent years.
Allow medical licensing boards to discipline doctors and other health professionals who violate prescription limits.
Permit people to create an “advanced directive,” notifying a health care provider that they don’t want to be prescribed an opioid.
Sen. Ron Stollings, D-Boone, predicted that the bill will prompt some physicians to stop prescribing pain medications altogether, leaving many patients without medications they need.
“I think there are going to be some unintended consequences on this,” said Stollings, a doctor, “and you’re going to hear about them from patients across the state who have chronic pain.”