Opioid plan clears its first hurdle

Committee advances plan that is priority for governor

PHOENIX — A far-reaching plan designed to help put a dent in opioid abuse in Arizona cleared its first legislative hurdles Tuesday, as a pain management physician warned lawmakers to be cautious.

Dr. William Thompson told members of the House Health Committee a key reason for the opioid crisis is not only the increasing focus on chronic pain as a legitimate complaint, but also government policies. Thompson said the policies allowed doctors who really “didn’t know what they were doing” to prescribe pain medications.

And there’s something else.

Thompson said that many doctors are rated — and paid — based on patient satisfaction. He said that system contributes to doctors’ willingness to give patients the pills that they want to eliminate their pain.

Thompson said that system needs to be changed to empower doctors to say “no” when appropriate.

The legislation, approved unanimously by the health committee, is designed to address at least some of that. It also received approval in the House Rules Committee.

The legislation includes both a requirement for doctors in training to get educated on opioids, as well as a mandate that doctors who prescribe opioids receive continuing medical education on the drug. It also includes limits on initial prescriptions: five days in most cases and 14 days following surgery. And the measure has various reporting requirements, designed to keep patients from “doctor shopping.”

Managing pain

While testifying in support of the measure, Thompson urged lawmakers to take care.

“We’re here in part because of well-meaning policy that was not well thought out,” he said. That started with making “pain” a vital sign, with people interested in the suffering of patients.

“And then creative marketing by drug companies created this problem,” Thompson said.

What concerns him now, he said, is the Legislature creating yet more flawed policies, despite its worthy goal of saving lives.

“I want to make sure that we think this through, like we have with stakeholder meetings, and make sure that our policy here doesn’t have unintended consequences,” Thompson said.

“There’s no profession on this earth that wants to be regulated any more,” Thompson conceded. But he added that there are “thought-out” exemptions that allow for doctors to prescribe higher doses, and for longer period of time, in situations where that is necessary.

Governor

On Wednesday, Gov. Doug Ducey said in a rural-media conference call he has called for a special session on the Arizona Opioid Epidemic Act. He said it is expected to pass the Senate this week.

“We want to make sure that people who are suffering from chronic pain are going to still have access,” Ducey said. “What we’re targeting is the bad actors,” such as doctors who prescribe too much. “For the chronic pain sufferers, there is no change.”

The Governor cited as proof Mohave County, a county with a population of 200,000, where 6 million pills were prescribed last year.

“We’re going to distinguish between those already on it and those not yet … preventing future addictions,” he said, focusing on “first fills” of prescriptions.

Ducey said the state does not pretend to be a medical doctor, “(and) I am not a medical doctor,” but he is interested in public safety.

Tim Wiederaenders, the Courier’s senior editor, contributed to this article.