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Patients Deserve Clarity on Proposed Pain Relief Limitations

Fraser Cobbe

Orange County Medical Society

Seminole County Medical Society

As the Florida Legislature quickly advances legislation to address the opioid crisis, it is critical that they fix the ambiguity in the bill that could have a significant impact on patients.

It is clear that the state must take action to reduce the supply of opioids in the community and there is a great deal to like in the bill. However, the 3-day (7-day) limitation on opioids is extremely vague and must be clarified so patients are fully informed on what pain relief will be available after major surgery or trauma.

With a month gone in Session, when you ask in the halls of the Capitol, there remains no consensus on the cornerstone of this proposal.

Does the bill enact a hard cap of 3-days for an entire acute episode? Or is this just a 3-day limitation on individual prescriptions that can be re-issued by your treating physician?

That is a fundamental question that must be answered. For a patient in severe acute pain, the difference between "slow and low" and "yes or no" is drastic.

If the Legislature is unable to clearly articulate the intent of their language, patients will be left in a quagmire of interpretations by local health care professionals. The consequences for patients would be severe.

The lack of clarity on the language has also prevented a philosophical debate on whether it is appropriate for the government to limit access to pain medication even when the patient is fully aware of the risks and potential ramifications. Florida could be the first state in the nation to enact a hard cap on access to opioids. Are we as citizens alright with this?

Just this week, during the State of the Union Address, the President of the United States promoted the "Right to Try" movement. The "Right to Try" empowers patients to weigh the risks of experimenting with unproven but promising medications if they feel that is a decision they must make to prolong or enhance their quality of life. Yet in Tallahassee, there has been no debate on whether we are comfortable with the government preventing a fully informed patient from taking an approved medication to address their acute pain.

There is no doubt that opioids are dangerous, but they are the current standard of care for postoperative pain relief and there is significant scientific evidence of their efficacy. This is not experimental medicine. But it is medicine that carries major addictive properties that must be carefully weighed and monitored by patients and their treating physicians.

The medical profession is fully aware that patients that suffer major trauma or undergo major surgery will have pain beyond the 3 or 7 day restrictions included in the bill. Patients deserve clarity on the most significant component of this proposed legislation.

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