Viewpoints: 2 physicians on the pros, cons of opioid prescribing limits

Many physicians are split on whether regulating opioid prescriptions and dosages is an effective way to address the opioid epidemic, according to a pair of op-eds published in The Wall Street Journal.

Richard Larson, MD, PhD, executive vice chancellor and vice chancellor for research at the University of New Mexico Health Sciences Center in 2018, believes government intervention is the only way of curbing the opioid epidemic.

"While many observers have noted the need to limit the aggressive marketing practices of drugmakers and lax controls on the distribution of opioids, they sometimes overlook another serious issue: the overprescribing of legal opioid drugs by physicians, dentists and other healthcare providers," Dr. Larson wrote. "Without strict government regulation, that problem won’t be solved."

Dr. Larson supports a three-day prescription limit for outpatients with acute pain and believes adolescents should not receive opioids in the outpatient setting. He also believes health systems should be required to implement opioid stewardship programs to monitor providers' prescribing habits.

In contrast, Halena M. Gazelka, MD, assistant professor of anesthesiology and perioperative medicine and practitioner of pain medicine at 2018 Minnesota based Mayo Clinic, believes  limits on prescriptions will do more harm than good.

"It goes without saying that opioids should be prescribed in the smallest quantity necessary to address the clinical need, but government limits on the ability of physicians to decide the appropriate use of opioids for their patients aren't the answer," Dr. Gazelka wrote. "They could end up doing more harm than good, by depriving millions of people of the pain relief they desperately, and legitimately, need."

Dr. Gazelka supports physicians prescribing the right medication, the right dosage for each patient  instead of rigid prescribing rules. She also believes government intervention should be utilized in improving access to opioid alternatives, which are equally effective, but less likely to be covered by insurance plans.

Dr. Gazelka also believes physicians should be required  to undergo education on the risks of long-term opioid use and strategies for safe prescribing.

More articles on opioids: 

Only 1 in 5 women screened for addiction before receiving opioid prescriptions
Big retail, U.S. Congress embrace EPCS in growing push to require E-prescribing for opioids
China denies claims it fueled US opioid epidemic

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