Representative Tom MacArthur Cosponsor of Bill Limiting Length of Opioid Prescriptions

Oct 18, 2017

Representative Tom MacArthur, whose 3rd New Jersey Congressional District includes much of northern Ocean County, half of Stafford Township and all of Barnegat Township, has, along with Rep. Annie Kuster (D-N.H.) and Rep. Phil Roe (R-Tenn.), introduced legislation, the Opioid Addiction and Prevention Act of 2017, which would limit initial post-acute care opioid prescriptions to a 10-day supply.

“Drug addiction has impacted so many families in New Jersey and in many communities across the country,” said MacArthur, a co-chairman of the Bipartisan Heroin Task Force. “For far too many Americans, this addiction is starting not on the streets, but in the medicine cabinet.”

“It is clear that the historic rise of opioid addiction in America was fueled in part by the excessive prescription of opioid drugs,” said Kuster, another co-chair of the task force. “While seeking to relieve patients of their pain after surgery or other procedures is well-intentioned, it is troubling that Americans consume about 80 percent of the world’s supply of opioid medications. This legislation would address the crisis by encouraging prescribers to provide, when appropriate, non-opioid alternatives prior to opioid medications, and if patients are to receive opioids, they will only receive a dosage and amount necessary to relieve their pain.”

Roe is not only an elected official, but also a doctor.

“As a physician,” said Roe, “I am keenly aware that patients may need pain medication following a medical procedure or hospital stay, but patients experiencing intense pain that lasts 10 days should be evaluated further by their physician. The reality is too many people become addicted to these drugs because their initial prescriptions keep them on these drugs longer than necessary. Furthermore, excess unused prescriptions too often end up as a supply source for addicts, including family members.”

The basis for the legislation was a March 2017 article in the Centers for Disease Control and Prevention’s Mortality and Morbidity Weekly Report. That article reported, “The probability of long-term opioid use increases most sharply in the first days of therapy, particularly after 5 days or 1 month of opioids have been prescribed.”

The bill would be moot in New Jersey, one of 17 states that have already passed more-restrictive legislation limiting the length or dosage of initial opioid prescriptions. In February 2017, Gov. Chris Christie signed a bill that sailed through the Legislature (the Assembly passed it by a 64-1 vote with five abstentions) that limited such prescriptions to five days. Kentucky, according to, was even more aggressive, passing a law with a three-day supply cap. The Opioid Addiction and Prevention Act of 2017 would not preempt state law in states that have more-limited timeframes for initial prescriptions, nor would it have any impact on patients battling chronic pain, such as that caused by cancer.

Macarthur’s legislation was born as a compromise of sorts. Note that it was predicated on the CDC report that specifically mentioned five days of opioid use as a tipping point toward long-term use. So why 10 days instead of five?

The answer to that question is opposition by physicians, who object to the government interfering in doctor-patient decisions. The New Jersey  bill, for example, was opposed by the Medical Society of New Jersey, the state’s largest physician lobbying group. So a compromise was worked out even for that seemingly drastic bill – the law allows New Jersey’s physicians to add another five days to the prescription after the fourth day if the pain has not subsided.

— Rick Mellerup


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