Opioid Prescription Limitations Worry Florida Doctors

By Paul Gaita 02/07/18

One of the proposed measures would limit opioid prescriptions for acute pain to a 3-7 day supply.

A doctor holding a pill bottle and talking to a patient.

A pair of bills under consideration by both House and Senate committees in Florida that seeks to reduce prescriptions for opioid pain medication has come under fire by physicians who argue that the restrictions could prove problematic and even dangerous for patients, especially those recovering from surgery.

The bills are a priority for Governor Rick Scott and fellow lawmakers, who are concerned about mounting opioid-related overdoses in the Sunshine State. Medical professionals are in agreement that efforts to fight opioid abuse are crucial, but are voicing their concerns over prescription limitations and issues regarding the state's prescription monitoring program before the House and Senate committees.

Chief among the physicians' issues with the bills is limiting access to pain medication for individuals recovering from major surgery, or those with limited mobility or access to transportation. As surgeon Dr. Bradon Luskin told a Florida Senate committee on January 10, "It's just not reasonable for somebody who's incapacitated to have to come back every three to seven days."

Other medical professionals viewed the limits as lacking in practicality or flexibility for both patients and doctors. "I don't think any of us, as competent physicians, would write a prescription that wasn't medically necessary," said orthopedic surgeon Hank Hutchison, speaking before a House Appropriations committee in January. "Patients are different. Their pain is different. And we treat them all differently."

For Luskin, the imposed rules prevent doctors from applying an individual approach to patients without risking a legal breach. "There are guidelines that allow doctors to tailor and modify plans for patients and not be under penalty," he said. "When you put something into law, either you are following it or breaking it."

Legislators in both the House and Senate were receptive to the doctors' concerns. "We're not trying to tell the doctors and the medical community how to practice," said Rep. Jim Boyd (R-Bradenton). "They understand [the opioid issue] is a huge epidemic." Committee Chair Dana Young (R-Tampa) also saw the concern over post-operative care as a "reasonable question [and] there are several ways that can be addressed."

Doctors also expressed concerns over Florida's prescription drug monitoring program (PDMP) which, under the proposed bills, will also be revamped. Currently, the state's medical professionals are not required to check the PDMP before issuing a prescription for a controlled substance. As the Daytona Beach News-Journal noted, many are not even registered with the program, but the new legislation will make it mandatory to review a patient's prescription history before writing new ones.

Upon hearing from doctors like pain management physician Dr. Alan Miller, who stated that the PDMP in its current form is difficult to use, Young noted that these concerns "should be a wake-up call for us that we can certainly improve the quality of our PDMP."

Though doctors have voiced their issues with the proposed legislation, both bills have support in the House and Senate of the Florida legislature, and are expected to go forward to the next phase, which is another committee meeting before heading to the floor of both bodies for a vote.

Bill sponsor Senator Lizbeth Benacquisto (R-Fort Myers) believes that their progress will be a smooth one. "I think the bill is very narrowly focused for a good reason," she said. "I don't anticipate a tremendous amount of changes."

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Paul Gaita lives in Los Angeles. He has contributed to the Los Angeles Times, Variety, LA Weekly, Amazon.com and The Los Angeles Beat, among many other publications and websites.