A reality based independent journal of observation & analysis, serving the Flathead Valley & Montana since 2006. © James Conner.

2 February 2017

Rep. Zach Brown’s physician handcuffing opioids bill


No one ever lost an election by endorsing mom, apple pie, and the flag, or by opposing drug abuse. Perhaps with those political truths in mind, and certainly with the intent of doing the right thing, Rep. Zach Brown (D-Bozeman) is preparing legislation, LC1891, still in draft form, with the title “An Act Limiting Medical Practitioners with Prescription Authority from Writing More than a 7-Day Supply of Opioids on a First Prescription with Certain Conditions and Exceptions.”

It’s an unnecessary bill that would handcuff physicians and result in some patients not receiving strong enough medication for their pain.

The 7-day limitation approximates the Center for Disease Control’s current, and draconian, guidelines for prescribing opioids for chronic pain. It also creates more paperwork for physicians, and imposes more duties on pharmacies.

Section 1.

(3) Conditions for obtaining a second prescription of an opioid drug after an original prescription of up to 7 days include:

(a) documentation by the medical practitioner with prescription authority for opioids in the patient’s medical record and an indication of why an alternative to the opioid drug was not appropriate to address the medical condition; and

(b) (i) for an adult, a consultation with the medical practitioner and payment of any required copay on each subsequent prescription;

(ii) for a minor, a consultation with the medical practitioner and a subsequent one-time second prescription unless the conditions in subsection (2) apply.

(4) The medical practitioner with prescription authority shall indicate on the prescription that the prescription is not intended for chronic pain.

(5) (a) A pharmacist filling an opioid prescription shall ask for the patient’s identification or identification by the patient’s custodial parent, guardian, or other person having legal custody if the patient is a minor.

Even if these are good ideas — and I’m far from convinced that they are — why must they be hardwired into Montana’s statutory law? What is the crisis that justifies the legislature’s politicians substituting their amateur medical judgement for the professional medical judgement of Montana’s physicians?

What is the purpose of Subsections (3)(a) and (3)(b) other than imposing a paperwork and logistics burden on physicians with the intent of discouraging them from prescribing an opioid?

Brown’s bill strikes me as premised both on a terrible fear of drug addiction, and on a cruel belief that using opioids to counter agonizing pain is a moral weakness, a character flaw, that denies the afflicted the opportunity to earn God’s grace by courageously enduring great suffering.

Only two classes of Montanans will benefit if this bill becomes law: (1) politicians, who can claim they’re curbing drug addiction by placing restrictions on irresponsible physicians, and (2) the pill police, whose job security will increase. Everyone else will suffer.