One week before New Jersey implements one of the nation's toughest regulations of prescription opioids, doctors are raising concerns it could go too far.
The law limits initial opioid prescriptions for acute pain to a five-day supply, though it allows doctors to renew it for another 25 days if a patient remains in pain. But as a measure of the stricter checks and balances, the new rules call for doctors to have a consultation with a patient about a request for a prescription renewal to ensure it is really needed.
New Jersey’s law is tougher than national guidelines for prescribers, which limit initial prescriptions to a seven-day supply.
Doctors agree that the opioid addiction epidemic that has led to hundreds of overdose deaths in New Jersey, and thousands nationwide, must be addressed. But some say the new law could make it difficult for patients who truly are in serious pain to obtain relief.
“The rules are very set in stone, it was rushed through, it was done too fast,” Dr. Louis Brusco Jr., chief medical officer of the Morristown Medical Center, told Fox News after a recent forum where state officials explained the new regulations.
State officials say they’re waging no less than a war against a deadly epidemic.
“When I learned that eight of 10 drug overdose deaths began with prescription painkillers, I knew we had to act right away,” New Jersey Attorney General Christopher Porrino told Fox News. “We promulgated these rules in response to an emergency. There’s no time to waste.”
Joseph Fennelly, an internal medicine doctor who has a practice in the town of Madison, agreed that enforcement must go hand in hand with providing the needed treatment to relieve people who are in great pain.
We promulgated these rules in response to an emergency. There's no time to waste.
“Medicine is always caught between following the science and law, and recognizing the human side,” Fennelly said.
Brusco stressed that he fully supports the idea that doctors are a crucial part of addressing the opioid addiction epidemic.
“There is no question that prescribers need to do better job of vetting [patient requests for painkillers], and worrying about alternatives and addiction,” Brusco said. “We have to take a burden of responsibility upon ourselves. But we have to remember that we are treating patients. Enforcement has to be fair patients.”
Gov. Chris Christie, who was named to President Donald Trump’s task force on opioid addiction, has made fighting the opioid epidemic a key cause of his administration. Last year, the state disciplined 31 doctors for related offenses, and is criminally prosecuting some of them.
“Bad doctors are a small minority,” Porrino said. “But a bad doctor is worse than a street corner drug dealer – a doctor is someone who is shrouded in the public trust. A doctor has to be treated more harshly than a street drug dealer.”
Bad doctors are a small minority. But a bad doctor is worse than a street corner dealer -- a doctor is someone who is shrouded in the public trust.
State officials say they will closely monitor compliance with a requirement that prescribers register for the New Jersey Prescription Monitoring Program, or NJPMP, which tracks drug prescriptions, a patient’s opioid history, pharmacies involved, among other things.
If they find that a healthcare provider has “indiscriminately prescribed” opioids, they can expect criminal charges, Porrino said.
There is no question that prescribers need to a better job of vetting, and worrying about alternatives and addiction. We have to take a burden of responsibilty upon ourselves. But we have to remember that we are treating patients. Enforcement has to be fair to patients.
“We understand that some feel the law is too strong,” Perrino said. “I can argue that it should be even stronger.”