Doctors Concerned over Haslam’s Opioid Proposal

The state’s leading organization representing physicians is expressing concern about Gov. Bill Haslam’s recently released proposal to combat the opioid crisis.

On Friday, the Tennessee Medical Association issued a statement outlining the position taken by its board of trustees, saying Haslam’s proposal “interferes with the physician-patient relationship.”

The organization said the proposal would place additional burdens on physicians who must utilize the state’s control substance monitoring database while writing prescriptions. And it was critical of Haslam’s proposal to limit an initial opioid prescription to a five-day supply, with “appropriate exceptions.”

“The governor’s proposal fails to protect patients who are suffering from legitimate chronic pain,” the statement said.

“A one-size-fits-all, five-day limit on opioid prescriptions could adversely impact some patients who do not respond to alternative pain treatments or other scenarios, such as those recovering from invasive surgery.”

Last month Haslam unveiled a $30 million plan to combat the state’s deadly opioid epidemic, which now claims at least three lives a day in Tennessee. More than 1,600 residents died from drug overdoses in 2016 — a number experts say is likely an under-count.

Opposition to the five-day limit is not limited to the TMA.

Last year, as New Jersey lawmakers were considering a similar five-day limit, physicians balked at the proposal, calling it an “intrusion into the practice of medicine.”

Last month, in his final State of the State speech, former Gov. Chris Christie said the state’s new opioid law has resulted in a 15 percent decrease in prescriptions.

The TMA pointed out the state does not have enough certified pain specialists to care for all those suffering from legitimate chronic pain. It criticized the prescription limit plan for interfering with doctor-patient relationships.

“Doctors should not be forced to refer patients to a pain management clinic when a five-day opioid supply is ineffective,” the statement said.

The organization makes several recommendations, including limiting dispensing instead of prescribing. It suggests limiting initial filling of prescriptions at pharmacies to seven days.

Another recommendation the group makes is requiring insurance companies to pay for non-opioid pain management treatments.

Similar recommendations have been made in others states, including Arizona.

Haslam’s plan does not include a similar requirement.

In addition to such concerns, the organization is calling for the governor’s bill to have a sunset date — a mandatory expiration — of 2021 in order to allow those involved to evaluate the effectiveness of the legislation.

Beyond the organization’s concerns, doctors offered some praise.

“It is encouraging that Governor Haslam is dedicating more funding for prevention, treatment and law enforcement,” they said.

Responding to the TMA’s statement, Jennifer Donnals, a spokeswoman for Haslam, said the state needs to take action on the opioid crisis.

“We are hopeful all stakeholders, including the TMA, will partner with us to recognize the urgency and achieve meaningful results.”

Anita Wadhwani contributed to this report.

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