Opioid Prescription Guidelines Now in Effect

May 18, 2018 06:58 PM

3.5 million opioid prescriptions were written in Minnesota in 2016, and at least half of those pills ended up in the wrong hands, according to the Department of Human Services.

RELATED: Lawmakers Debate Opioid Taxes as States Grapple with Crisis


It's one reason new state guidelines were established to limit pills the number of being prescribed.

"These guidelines are really, really strict. They're the strictest I've ever seen," Dr. Mark Willenbring with Alltyr Clinic said.

He founded the St. Paul-based individualized treatment and therapy clinic about five years ago and has been studying addiction for nearly 40 years.

"I think we needed to cut back but I think we've cut back too far," he said of the state's new prescription guidelines that went into effect at the end of April.

In short, the guidelines outline three recommendations for providers:

1.) After an injury or surgery, avoid prescribing more than a three-day supply, or 20 pills.
2.) After that, prescribe opioids only for a seven-day time period and reassess.
3.) For chronic pain, avoid starting opioid therapy whenever possible and carefully manage any patient who remains on medication.

"I've got several patients right now that I'm maintaining on opioids for chronic pain and they're doing very well," Willenbring said. "Now, you take them off of that and they will not do well at all. They will go from 16 hours up and active a day to two hours up and active a day."

"These are narcotics," Acting Commissioner for the Department of Human Services Chuck Johnson said. "They change your brain chemistry so you use them enough over time, and you need to have more and more."

Johnson says the most dangerous period of time is within the first 45 days of use, and that addiction can happen within the first five days.

Minnesota Opioid Action Plan

"This isn't something that we're forcing on anyone," he said. "I think the whole healthcare industry and healthcare professionals are recognizing that there's a problem we need to address."

The state will monitor prescribers and flag those who stray from the guidelines, first working to help them adjust to the changes but will eventually impose repercussions if needed.

"If we have individuals who continue to overprescribe and not follow the guidelines, they could be removed as providers from our programs," Johnson said. That includes Medicaid and MinnesotaCare.

RELATED: Dayton Proposes Tax on Drug Companies in Effort to Combat Opioid Epidemic

"We cover about 20 percent of the state through our programs," he said.

"It's not going to do anything for the opioid problem in the state because the problem has shifted," Willenbring said. He believes the real problem lies with street drugs like heroin.

"It's mainly going to deprive people who need pain medication from getting it," he said.

The state can only oversee so much and is also working with individual health care providers to help monitor prescribers.

There are some exceptions to the guidelines. Examples include those who are addicted and depend on medically-assisted therapy, those in cancer treatment, and those in hospice care.

You can read more about the guidelines by clicking here.


Katherine Johnson

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