by Dennis Dimitri, M.D., President, Massachusetts Medical Society
Led by two members of the Massachusetts congressional delegation, another encouraging step has been taken in the battle against opioid abuse, and it is a prime example of the value and effectiveness of the Massachusetts Medical Society’s grassroots physician advocacy.
In a bipartisan effort, Senator Elizabeth Warren and Representative Katherine Clark, along with Senator Shelley Moore Capito (R-West Virginia) and Representative Steve Strivers (R-Ohio), have filed legislation in Congress to allow the partial filling of opioid prescriptions.
The Reducing Unused Medications Act would permit prescriptions for pain medications to be partially filled at the request of the physician or patient. The goal of the bill is simple: to reduce the amount of unused pain pills, thereby limiting the number of drugs that can be diverted.
It is a critically important goal. One of the major factors contributing to the opioid epidemic is the availability of prescription medications. Physicians have come to realize that, in their efforts to reduce pain, too many prescriptions have been written. This overprescribing has led to the diversion of medications, so much so, in fact, that the majority of individuals – estimates are about 70 percent – who misuse or abuse pain medications get them from prescriptions written for friends or family. The number of Americans 12 years of age and older who report using prescription pain medications for nonmedical use approaches 12 million.
A partial-fill prescription would help patients balance the need to relieve pain with an adequate supply of pain medication by only filling part of the prescription. Should they need additional pain relief, patients will be able to return to the pharmacy to fill the remaining portion of their prescription. Partial-fill prescriptions can be a useful tool for physicians, many of whom find it genuinely hard to know how much pain medication to prescribe.
The idea of partial-fill prescriptions began within our own medical society, with the concept first surfacing at a Worcester North District Medical Society meeting with my predecessor, Dr. Rick Pieters. With MMS advocating for its adoption, the idea caught the attention of elected officials at both the state and Federal levels.
Massachusetts State Senator John F. Keenan (D-Quincy), who served as Vice Chair of the Special Senate Committee on Opioid Addiction Prevention, Treatment and Recovery Options, included a provision for it in a bill the Senate passed last year, and Senator Warren and Representative Clark have now filed a bill in Congress.
Questions remain, however, about the legality of partial-fill prescriptions. Current Drug Enforcement Administration regulations allow for partial fills for Schedule III, IV, and V, but prohibit them, with few exceptions, for Schedule II.
The legislation filed by Senator Warren and Representative Clark (which follows an effort last year by both legislators, supported by the entire Massachusetts Congressional delegation and dozens of others members of Congress, urging DEA to allow such prescriptions) elevates the importance of this step in the fight against opioid abuse. Most importantly, the bill would provide clarity from the DEA about the legality of partial-fill prescriptions and permit states to act.
MMS strongly supports partial-fill prescriptions and believes they can be an important tool in fighting opioid abuse. Last year, at the Massachusetts State House we testified in support of House Bill 1929, legislation permitting partial-fill prescriptions, with the caveat that the bill allow for the remainder of the partial-filled prescription to remain valid.
Improving the way prescription painkillers are prescribed can reduce the number of people who misuse, abuse, or overdose from these powerful drugs, while making sure patients have access to safe, effective treatment. The partial-fill concept is one way to do that, and we are encouraged by and strongly endorse the action of Senator Warren and Representative Clark.
The President’s Podium appears periodically on the MMS Blog, offering Dr. Dimitri’s’ commentary on a range of issues in health and medicine.