The final word: Working together to make a difference in the opioid epidemic

Sunday, July 01, 2018 12:58 PM

The Honorable Irene Aguilar, MD, (D), Senate District 32, and The Honorable Jack Tate, (R), Senate District 27

Earlier this summer Gov. John Hickenlooper signed into law next-generation legislation aimed at reducing the risk of prescription drug abuse and diversion of opioids while balancing the clinical needs of your patients and your own professional judgement as to medical necessity. Like every state, the policy challenge is drafting an approach that requires medical insights and expertise in a lawmaking body made up of mostly non-physicians, and few if any experts in pain treatment and addictive medicine.

That is why, in response to the epidemic rise in opioid addiction and the wreckage left in its wake to communities and families, Colorado lawmakers have relied on the expertise and wisdom of real-world organizations from the front lines, especially the Colorado Medical Society. It is a sustained collaboration that assures your ideas have real-world applications drawn from the sometimes-contorted process of lawmaking.

The urgent need to reverse the downward spiral of opioid abuse only succeeds with the cooperation of the medical profession. The Colorado Medical Society’s leadership in this endeavor has been exemplary, though not without conflict and controversy. In addition to bringing the credibility and influence of your organization to the statehouse to help reframe the thinking and biases of a diverse legislative body, you convened a formidable panel of experts on the CMS Special Committee on Prescription Drug Abuse, who consistently brought their insights and experience into the halls and chambers of the Legislature and executive offices.

While we have labored at grinding out the laws to buttress a statewide effort, with your support, Colorado physicians have also moved the needle by rethinking pain treatment and modifying those standards and protocols. Your own surveys show an impressive, determined effort. Between 2013 and 2017, the number of opioid prescriptions decreased by 21.1 percent in Colorado. Nearly 40,000 physicians and other health care providers were registered with the PDMP in Colorado in 2016 and queries increased from 683,000 in 2014 to 1.5 million in 2016. Nearly three-quarters (70 percent) of CMS physicians report taking CME regarding opioids in at least the past two to three years.

With the enactment of this body of law, similar to – but improved upon – legislation passed by other states in the last 18 months, we are stepping up the pace but not while stranding your patients who would suffer needlessly by globally limiting patient access to pain treatment.

Step by step, we can only continue progress with the active support and compliance of your profession. In exchange for that cooperation, we have set a timer on this. SB 18-022, Clinical Practice For Opioid Prescribing, expires in September 2021. We can review, reboot and reenact the parts of the policies that work, and discard what has not. It will be up to us – together.