Fatal opioid overdoses jumped 42% across the nation during the COVID-19 lockdown. The nation’s leading organization for doctors thinks it knows how to solve the problem. Though some folks might have a hard time understanding their reasoning. They say the answer is easier access to prescription pain medication and the distribution of clean needles.
In a statement, the American Medical Association said, ” The AMA is greatly concerned by an increasing number of reports from national, state and local media suggesting increases in opioid-related mortality—particularly from illicitly manufactured fentanyl and fentanyl analogs.”
Forty out of fifty states reported a spike in opioid-related deaths. Medical professionals worried that the isolation caused by COVID-19 could worsen addiction and mental health problems.
The AMA said it was happy that the U.S. Substance Abuse and Mental Health Services Administration and
U.S. Drug Enforcement Administration (DEA) loosened the rules for providing buprenorphine and methadone to patients with opioid use disorder. They’re also happy that states like Ohio loosened their telehealth rules to allow patients to be evaluated virtually.
But they still want more changes. The AMA is calling for states to remove regulations about dose, quantity, and refills on controlled substances prescribed for pain medication.
Opioid Prescription Regulations
Back in 2017, Ohio instituted these guidelines:
- Doctors may prescribe no more than seven days of opioids to an adult.
- No more than five days of opioids can be prescribed in the initial prescription for minors, and only after the written consent of the parent or guardian is obtained.
- Physicians and other licensed health care prescribers may prescribe opioids in excess of the day supply limits only if they provide a specific reason in the patient’s medical record.
- Except as provided for in the rules, the total morphine equivalent dose (MED) of a prescription for acute pain cannot exceed an average of 30 MED per day.
Ohio added additional prescribing guidelines for pain medication back in the fall of 2018. These rules were designed to combat the over-prescription of drugs by so-called “pill mills” and to offer guidelines to prevent well-meaning doctors from overprescribing.
Under the current rules in Ohio, doctors must re-evaluate patient opioid use at safety checkpoints.
- 50 morphine equivalent dose (MED) is the first checkpoint. Doctors must re-evaluate the condition, look for signs of overuse, and obtain written informed consent.
- 80 MED is the second checkpoint. Doctors must ask for written consent again and offer a Naloxone prescription.
- 120 MED is the final checkpoint. At this point, the patient must have a pain specialist.
The AMA also called on states to remove all barriers to sterile syringe and needle distribution programs. While many say programs that distribute clean needles to drug addicts help prevent the spread of HIV and hepatitis C, results have been mixed. Charleston, West Virginia shut down their needle exchange due to numerous problems.