Close to Home: Improving access to abuse-deterring medication

In the United Sates in 2013, the number of prescription drug abusers was more than double those who abused heroin, cocaine and hallucinogens combined. The sad fact is that more than 60 people die every day in the United States from prescription drug overdoses.

As a dentist, I treated patients with legitimate oral and facial pain. Tragically, I also saw my share of people attempting to engage in “doctor shopping” to feed an addiction or pattern of abuse. Narcotic pain medications, or opioids, have an important role in our health care system. They provide effective relief for the millions of Americans who suffer from chronic pain. But too easily they are getting into the wrong hands. Almost 1.5 million Californians, ages 12 and over, were estimated to have abused painkillers in the previous year, according to a 2011 government survey.

The rate of hospital stays involving opioid overuse among adults increased more than 150 percent between 1993 and 2012. Of particular concern to me is recent information showing that hospitalization rates for opioid overdoses in Mendocino County are twice the California average.

Crushing, cutting and dissolving pain pills for injection or inhaling through the nose is popular and dangerous among serious addicts and abusers. It is also what most often leads to overdose and death. This is why I introduced AB 623, legislation that would widen access to a proven new technology that is showing tremendous results in reducing a particularly deadly form of prescription drug abuse.

Scientists have developed formulas for opioid pills that cannot be manipulated in ways that are popular with abusers or that use other methods to deter altering the pills for misuse. These abuse-deterrent formulas have been approved by the U.S. Food and Drug Administration and provide patients with the same pain relief as conventional opioids, but they incorporate breakthrough technology designed to protect against manipulation and abuse.

Scientists demonstrating this technology have taken mortar and pestle, hammers and sledgehammers to these pills. Instead of turning into a fine powder like conventional tablets, the pills stay intact and remain impossible to inject or inhale.

AB 623 seeks to limit opioid abuse in several ways in California. It would make it easier for doctors to prescribe a less-than-30-day supply of opioids, in order to limit pills available for theft and misuse. It also would expand providers’ ability to prescribe abuse deterrent formula medication when they determine it is appropriate, without requiring patients to try other less effective or less appropriate drugs first. Finally, it would result in pharmacists informing patients how to store and dispose of opioids as part of their counseling.

Sponsors of AB 623 include the American Chronic Pain Association, the U.S. Pain Foundation, the Power of Pain Foundation and national organizations dedicated to helping those who suffer from pain in safe and responsible ways. This bill also is supported by law enforcement, including the California State Sheriffs Association and by health care providers, pain management specialists and patient advocacy groups including the Partnership for Drug Free Kids, Healthy African American Families and the American GI Forum of California.

Abuse deterrent formulations have received widespread support nationally in law enforcement, medical, academic, pain advocacy and other communities. They are supported by the Office of National Drug Control Policy, the Community Anti-Drug Coalitions of America, members of Congress and the National Association of Attorneys General among many others.

AB 623 is a necessary first step to widen access to abuse deterrent opioids and to help providers get them to patients when they deem they are needed.

These newly formulated painkillers certainly won’t eradicate the misuse of prescription drugs, but they are part of the solution, and they should be accessible and affordable to those who need them. My legislation would encourage the use of abuse-deterrent formulas in most cases and would urge insurers and government health plans to cover them to keep down patients’ out-of-pocket costs. We must not miss this opportunity to help make our state a little bit safer for our children and all of our citizens.

Jim Wood represents the 2nd Assembly District, which stretches from the Oregon border to the Estero Americano, south of Bodega Bay, and includes all of Del Norte, Trinity, Humboldt and Mendocino counties plus part of Sonoma County.