We have an opioid epidemic in this country and in our state. The death rate from these drugs has nearly quadrupled since 1999, and continues to rise. Opioids are responsible for 91 deaths every day in the U.S. Nearly half of these opioid-related deaths were caused by prescription opioids. This predictably corresponds with a significant increase in opioid prescriptions for pain. While, at the same time, the amount of pain that Americans report has not changed much, according the Centers for Disease Control and Prevention.
Fixing this problem will not be simple. There is no cure-all, and all of us – doctors, pharmacists, patients and lawmakers – have an important role to play in this battle. With that in mind, I came into this legislative session determined to do something about the problem.
A piece of the puzzle less talked about, but no less important, is a critical moment in a patient’s treatment cycle: the disposal of leftover or unwanted medications. Saving extra, expired or unused medicine at home can actually be very dangerous – but a lot of people do it. In fact, according to the Journal of the American Medical Association, 61 percent of patients with leftover opioids intend to save them for future use. While this can be and often is an innocent act, what if these drugs get into the wrong hands and are accidentally or intentionally misused?
If we want to ensure medicines are used only for their intended purposes, and prevent these drugs from falling into the wrong hands and leading to long term abuse or addiction, then people need convenient and thorough access to information and convenient places to do the right thing. To that end, I’m sponsoring Senate Bill 826 to promote and make possible the safe disposal of medicines and drugs. As a pharmacist for 30 years, I know first-hand the need for a better and safer way to get rid of unused prescriptions, and pharmacists can help play a role in that effort.
This legislation would create a statewide approach, including allowing Missouri pharmacies to join the majority of other states that allow pharmacies to house kiosks for the collection of unused medicines. This bill also expands the types of drugs pharmacies can legally take back, and creates an education campaign for Missourians – a plan that would make safe disposal widely encouraged and attainable.
Another important factor in the fight against the opioid epidemic is keeping people from becoming addicted to these drugs in the first place. One proven way we can do that is to limit the initial prescription length for opioids. There is strong evidence linking the likelihood of long-term use with the length of the initial prescription. In fact, evidence suggests long-term use increases sharply after the third and fifth days of taking an opioid prescription, and jumps up again after the 31st day.
Supplied with this information, I filed Senate Bill 825, which would limit initial prescriptions of opioids to no more than a seven-day supply for the treatment of acute pain. The limit would not affect patients suffering from chronic pain, nor would it affect anyone undergoing treatment for cancer, receiving hospice care or palliative care or who are in long-term care facilities. This effort is not intended to stop people who are truly in pain from getting the help they need. Rather, it is an effort to keep those folks from falling into a trap of addiction that often leads to more serious drug use and the consequences that come with it. Twenty-three other states already have some type of limit, guidance or requirement related to opioid prescribing and we need to do our part in Missouri.
If we can limit a patient’s exposure to a highly addictive opioid on the front end, we can save a lot of pain, suffering and expense for the state and, most importantly, for those addicted to these drugs and their families. We have a moral obligation to face the challenges of this problem. Together, we can make our state safer and help save lives.
As always, I welcome your ideas, questions and concerns. You may contact me at the State Capitol as follows: (573) 751-1480, david.sater@senate.mo.gov or by writing to Sen. David Sater, Missouri State Capitol, Room 416, Jefferson City, MO 65101.
God bless and thank you for the opportunity to work for you in the Missouri Senate.