Senators Gillibrand and Gardner Introduce Legislation to Limit Opioid Prescriptions to 7 Days

On March 15, U.S. Sens. Kirsten Gillibrand (D-NY) and Cory Gardner (R-CO) announced bipartisan legislation that would limit the supply of initial opioid prescriptions for acute pain to seven days. The bill is called The John S. McCain Opioid Addiction and Prevention Act, named after the late Republican Senator who died of brain cancer in Aug. 2018 and was formerly leading this legislation.

The senators believe this legislation will help prevent and combat opioid addiction in the United States as the rates of drug overdoses and addictions continue to rise.

“If we want to end the opioid epidemic, we must work to address the root causes of abuse,” tweeted Sen. Gillibrand, who announced her Democratic candidacy for the 2020 presidential election on Mar. 17. “That’s why @SenCoryGardner and I introduced legislation to limit opioid prescriptions for acute pain to 7 days. Because no one needs a month’s supply for a wisdom tooth extraction.”

If we want to end the opioid epidemic, we must work to address the root causes of abuse. That’s why @SenCoryGardner and I introduced legislation to limit opioid prescriptions for acute pain to 7 days. Because no one needs a month’s supply for a wisdom tooth extraction.

— Sen. Kirsten Gillibrand (@gillibrandny) March 15, 2019

This is not the first time politicians have attempted to reduce opioid deaths and addiction by limiting access to prescription opioids. Pharmacies such as CVS and Walmart have put a seven-day limit on opioid prescriptions for certain conditions. Medicare enrollees have been limited to a seven-day supply of opioids for acute pain as well, with state Medicaid programs put “safety edits” in place for opioid refills. The Trump administration also released T.V. commercials highlighting the dangers of prescription opioids.

However, research has shown that limiting opioid prescriptions does not have an effect on the rates of death and addiction in the U.S. According to reports from the Centers for Disease Control and Prevention, opioid deaths in the U.S. are rising, with a 9.6 percent increase from 2016 to 2017. But this increase is due to fentanyl, not prescription opioids.

As the number of opioid prescriptions decreased from 2016 to 2017, the rate of deaths involving prescription opioids leveled off, while the rate of deaths involving synthetic opioids other than methadone (including fentanyl) increased 45 percent.

The announcement of the legislation was instantly met with backlash from the chronic pain community.

Some believe politicians should not make legislative decisions about medical treatment or interfere with the patient-doctor relationship.

I’d rather have doctors deciding how long I need pain medication for than politicians, thanks.

— roxane gay (@rgay) March 20, 2019

Stop, please stop. You're not qualified to decide what medication patients need. That should be between the doctor and the patient, period. I know you mean well, but the #opioidhysteria is causing real harm to people with real pain. If you want to help provide unbiased education.

— Happy Nihilist (@FuCtMessiah) March 19, 2019

Feminists have fought for years to get politicians out of the relationship between doctor and patient. How about we go after the drug companies who purposely developed these drugs to be as addictive as possible, and not doctors and people in pain.

— Ashley Nicole Black (@ashleyn1cole) March 20, 2019

Others pointed out that acute pain doesn’t always go away after seven days. By definition, acute pain can last anywhere from one second to six months. For some, differentiating between acute and chronic pain is not as clear-cut as it may seem. Though the legislation specifies “acute” pain, it still has the potential to affect those with chronic pain, as many still experience acute pain and injuries or have their pain classified as “acute” by doctors.

For many many chronic pain sufferers their long term disability is an arduous process to identify and treat. Their pain can be considered acute for quite a while before doctors are able to find out what the cause is. This will really cause everyone harm.

— Erin Biba (@erinbiba) March 19, 2019

For a while, most of my chronic issues were officially written as acute in my chart, because that was the only way my (pre-ACA) insurance company would cover anything.

— Callalily (@Callalily57) March 19, 2019

The problem with this is that not everyone is neatly sorted into categories of acute versus chronic pain. "Chronic" is a qualifier that is intensely gatekept by doctors, due in part to the stigma around opioid use.

This will backfire and severely hurt people.

— rys kv (@Rys_KV) March 19, 2019

But you know what someone DOES need a month of painkillers for?

A hysterectomy with complications.

A double knee replacement.

Your candicacy.

— Lynn Pounian (@Panger2019) March 20, 2019

Others say the legislation won’t combat opioid abuse; instead, they believe it will harm those with chronic pain, and potentially cause those struggling with addiction to turn to illicit street drugs. Many are asking the senators to do more research into opioid addiction and speak with medical experts as well as chronic pain patients.

Last year, the State of Michigan implemented a similar law. It's a disaster. It makes it harder for doctors to adequately treat patients' pain and hugely inconveniences patients. It's a horrible law. It's done nothing thus far to decrease opioid abuse.

— David Gorski, MD, PhD (@gorskon) March 20, 2019

So your plan is to push more people to heroin so that they have a higher chance of overdosing then they’ll be dead. I hate it

— Bяyan (@MurderBryan) March 19, 2019

The ratio on this tweet is a good opportunity to get clinical and research experts and patient advocates in the room and talk through this a bit more with evidence and logic on your side.

— Esther Choo MD MPH ????????‍♀️ (@choo_ek) March 19, 2019

A bill like this increases the likelihood of a situation like that occurring by 300%. Chronic pain patients would be left without relief and risk deadly side effects of not having their normal medicine. Absolutely ridiculous. You two need to meet with chronic pain patients.

— Robby Starbuck (@robbystarbuck) March 20, 2019

The Mighty has reached out to Sens. Gillibrand and Gardner and has yet to hear back.