Opioid Death Risks

FILE - This Tuesday, Feb. 19, 2013 file photo shows pills of the painkiller hydrocodone at a pharmacy in Montpelier, Vt. Accidental overdoses aren't the only deadly risk from using powerful prescription painkillers _ the drugs may also contribute to heart-related deaths and other fatalities, according to research published Tuesday, June 14, 2016. "As bad as people think the problem of opioid use is, it's probably worse," said Wayne Ray, the lead author and a health policy professor at Vanderbilt University's medical school. (AP Photo/Toby Talbot) ORG XMIT: NY647

Toby Talbot

State lawmakers are advancing legislation that takes aim at Louisiana's escalating opioid epidemic.

The House Health and Welfare Committee on Wednesday unanimously agreed to send legislation that would limit most first-time opioid prescriptions to a seven-day supply, and lawmakers took a step toward establishing an advisory panel to help coordinate the state's prevention and education efforts in response to the drug.

"We've done a lot of work over the past several years to address this crisis," said state Rep. Helena Moreno, a New Orleans Democrat who is sponsoring the prescription-limiting House Bill 192. "Obviously, a lot more needs to be done."

Meanwhile, the state Senate has signed off on legislation that would require that doctors and other prescribers consult the state's Prescription Monitoring Program before any initial prescription of a Schedule II drug, including opioids, and undergo three hours of continuing medical education every three years. That measure, Senate Bill 55, must now be vetted by the House.

Gov. John Bel Edwards, a Democrat, placed HB192 and SB55 on his list of priority legislation before the session started.

Opioids are a commonly-prescribed category of narcotic pain medication.

They include OxyContin, Percocet, Vicodin and codine. About 20 percent of patients who see doctors for non-cancer pain symptoms or pain-related diagnoses receive an opioid prescription, according to a 2016 Centers for Disease Control and Prevention report.

Louisiana has the sixth-highest opioid pain reliever-prescribing rate in the country, according to IMS Institute for Healthcare Informatics' analysis of a year-long period through June 30, 2016. It found that there were 102.3 opioid prescriptions for every 100 people, when counting new prescriptions and prescribed refills. The national average was 69.5 prescriptions for every 100 people during that period.

The state's drug overdose rate also outpaces the national average, fueled by the rise in prescription opioid abuse and the use of illicit opioids, like heroin, and synthetic black-market opioids, like fentanyl. The CDC placed Louisiana had the 19th highest age adjusted opioid OD rate in 2015.

"It's reached epidemic proportions," said state Rep. Joe Stagni, R-Kenner.

He said passage of legislation to combat opioid addiction will position the state to address the problem head-on.

"I'm really proud for once Louisiana is going to be out in front of it. We need to be," Stagni said.

HB192, which would limit first time prescriptions of opioids for acute pain to a week supply before patients have to get them re-upped. It also would limit all acute pain opioid prescriptions for children to seven days. The bill would not apply to prescriptions for chronic pain, cancer or palliative care, and the bill offers some exemptions when alternatives aren't available.

Nine states — Connecticut, Delaware, Maine, Massachusetts, New Jersey, New York, Pennsylvania, Rhode Island and Vermont — have placed similar limits on opioid prescriptions.

Moreno said that the goal is to keep prescription drugs out of the hands of people who don't need them. If a person were to get a prescription beyond the amount they need, for example, they could be inclined to keep the medicine in a cabinet.

"I can't tell you how many stories I've heard of people going in for minor procedures and they get a 30-day supply of Percocet," she said.

Dr. Karen DeSalvo, a public health expert who served as assistant secretary in the U.S. Department of Health and Human Services, said she also worries that medicines languishing in people's cabinets fall into the wrong hands.

"We know from young people that's sometimes where they get started," she told the committee.

DeSalvo said the opioid crisis is a public health issue and efforts to rein it in are "laudable."

"This bill is an important step forward," she said. "It's a step toward saving lives."

Ed Carlson, the chief executive officer at the addiction treatment center Odyssey House Louisiana, said that many clients who are addicted to heroin start out addicted to prescription opioids. He said that the problem is overwhelming programs across the state.

"We have to start the process of dealing with this epidemic," he said. "It's a state-wide epidemic."

Follow Elizabeth Crisp on Twitter, @elizabethcrisp.