Democratic presidential candidate Senator Kirsten Gillibrand (D-NY) and Sen. Cory Gardner (R-CO) have announced non-partisan legislation on opioids, which has been confronted at several levels with counter-reactions.
Gillibrand announced her plan on Twitter and wrote, "If we want to end the opioid epidemic, we need to work on the causes of the abuse. For this reason, @SenCoryGardner and I have introduced legislation to limit the opioid prescription for acute pain to 7 days. Because nobody needs a month for a wisdom tooth extraction. "
<p class =" Canvas Atom Canvas Text Mb (1.0em) Mb (0) – sm Mt (0.8em) – sm "=" text "content =" Gillibrand's Tweet received more than 17,000 answers, many of which were negative and critical to their plan. " data-reactid = "17"> Gillibrand's Tweet received more than 17,000 responses, many of which were negative and critical to their plan.
<p class = "Canvas Atom Canvas Text Mb (1.0 em) Mb (0) – sm Mt (0.8em) – sm" type = "text" content = "The journalist Abraham Gutman, of Philadelphia Inquirer responsible for legal and illegal drugs, responded with a long Twitter thread criticism of the bill. "data-reactid =" 18 "> Journalist Abraham Gutman, responsible for legal and illegal drugs at the Philadelphia Inquirer is answered with a long Twitter thread in which he criticized the proposed legislation.
Bad. Bad. Bad. Bad. Bad. Bad. Bad. Bad. Bad. Bad. Bad. Bad. Bad. Bad. Bad. Bad. Bad. Bad. Bad bad bad.
This is a bad policy that * NOT * will save lives and hurt chronic pain patients – including motivating people to commit suicide. We've seen that before. https://t.co/DDpCHWZdWU[19459003-AbrahamGutman(@abgutman) March 19, 2019
Following the negative feedback on the social media, Gillibrand published a post titled "I hear you – and me I." I want to get my bill right for Opioide. "In the post she wrote that she basically believes that medical care should be provided between physicians and patients and that the purpose of their bill should not be in the way, but rather to ensure that doctors prescribe opioids with a higher degree of control.
Gillibrand's office declined to comment. Gardner's office did not respond to several requests for comment.
"I do not think this is the way to do this"
A knowledgeable critic of the proposed legislation is Dr. Ryan Marino, an emergency physician and medical toxicologist at the University of Pittsburgh School of Medicine.
Although Marino is glad that the politicians want to get involved and help, "I do not think that's the way to go," he told ld Yahoo Finance.
The announcement states that the bill "would set a prescription limit of seven days for opioids so that a patient could not be prescribed more than seven days for acute pain at once, such as wisdom tooth removal or broken bone."
But "I have not seen how they define acute pain or acute problems," Marino said. "That's going to be a big problem because this definition is mine. The biggest problem with this proposed law."
Gillibrand & # 39's Medium Post emphasized that their bill would only apply to initial prescriptions, so those who need to top up acute pain would receive it at the discretion of their doctor, but Marino raised concerns about this aspect.
"This bill would make it so that [patients with severe pain] must see a doctor and get a new recipe, what the payment it's another appointment, transport there and another recipe, "Marino said. "It's an excessive burden on patients and doctors. If a good surgeon knows that his patients can call him on the eighth day, they may have been able to refill him. That will not be the case anymore. "
"There are many causes for the opioid crisis"
Another problem with Gillibrand's approach is her claim that over-elevation is a major cause of opioid abuse.
"There are many causes for the opioid crisis," Bradley Stein, director of the RAND Opioid Policy Center said Yahoo Finance. "Surely prescribing opioid analgesics, which they did not necessarily have to have, is one of the contributors, but to say that this is the main factor, I believe there are many others." [BrettGiroirDeputyHealthSecretaryandSeniorTheOpioidPolicyAdvisertotheDepartmentofHealthandHumanServicespreviouslytoldYahooFinancethatmanyfactorsplayaroleinthegenesisofthisopioidincludingthe"over-andinappropriateprescription"ofopioidanalgesicsforpatientsthe"availabilityandrisk"ofimportinglow-costhigh-potencydrugsand"theroleofstateandsociety"intheonsetoftheopioidcrisis
Basically, the overrun is just one tooth in the system of this epidemic.  According to the CDC, the overall prescription rate of opioids dropped from 2012 to 2017, reaching its lowest level in 10 years in 2017. In that year, however, "in 16% of the US states, enough opioid was issued. An ID card was issued for each person.
Stein commented: "As a nation, we are probably prescribing more opioid analgesics than we should or should be. I welcome the idea of reducing the number of prescribed opioid analgesics.
However, he added, "We must approach it so that there are a number of approaches that are clinically appropriate. It ranges from an attempt to encourage doctors and prescribers not to prescribe any opioids at all we have better alternatives, or to prescribe as few days as possible, if this is 3 days or 17 days or 14 days. The daily limit would exclude persons with chronic pain, cancer patients, hospice or nursing staff and patients being treated for palliative care pain.
She noted that this modeled on existing laws in 15 states.
However, Marino said that these laws "have shown no effectiveness" to curb the addiction.
"We do not know that seven are necessarily any kind of magic number, while six days or eight days might be better or worse," he said. "It's very arbitrary to begin with."
"Our Land has a formidable path to go … "
There are also potential financial implications associated with a bill like this.
The biggest financial burden is likely to affect patients, Marino said. As someone who works in an emergency room, he said he saw patients need to top up on medication, and going to the emergency room is the only option.
"I imagine that in this case the nature of the visits would increase. Marino said. "So that means another copay, long waiting times, and the expansion of ED overcrowding and the problems we have."
In 2017, nearly 49,000 people died of opioid overdoses, with the synthetic opioid fentanyl the largest Driver was. For the moment, Stein said, "Many of our deaths are driven by individuals. Maybe they are overdosing heroin or fentanyl. A response to the crisis must therefore consider a whole range of options that include ways to improve the prescription of opioid analgesics in that country. But it must also satisfy the enormous need for us to increase access to effective treatment in this country. … Our country has a great opportunity to ensure that people who want treatment receive access to their treatment.
In October 2018, President Trump signed a new Opioidsetz, which was described as "historically in the width". It aimed at combating drug trafficking and drug trafficking.
We need to consider a number of mitigation approaches, "Stein said. "This idea that there is a single cause may not sufficiently recognize the complexity of the crisis and the range of policy responses that we will really need to address them effectively."
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