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Opioid Prescriptions Now Have 3-Day Limit in Florida

Gov. Rick Scott signed legislation into law Monday that puts a limit on opioid prescriptions and provides $65 million to fight the epidemic statewide. He signed the bill at the "ground zero" of the opioid crisis -- Manatee County.

By Jessica De Leon

Gov. Rick Scott signed legislation into law Monday that puts a limit on opioid prescriptions and provides $65 million to fight the epidemic statewide. He signed the bill at the "ground zero" of the opioid crisis -- Manatee County.

The new law, HB 21, puts a three-day limit on most prescriptions for acute pain and toughens the drug control monitoring program. The bill also provides for additional treatment opportunities, recovery support services, outreach programs and resources to help law enforcement and first responders to stay safe.

"The bill will help limit the chance of drug addiction," Scott said. "The most important thing we can do is stop the addiction in the beginning."

The new law adds more than $53.6 million in funding, which with additional money promised in the budget, totals about $65 million dedicated to fighting the opioid epidemic.

Manatee Sheriff Rick Wells said even more money is needed.

"We need more and more funding to be distributed to the treatment side and deal with mental illness," Wells said after Scott signed the bill during a ceremony at a sheriff's office station in Bradenton. "On the law enforcement side, we are going to do what we do, but it's just not going to be enough. We just try to eliminate the source, but we have to help those who are struggling and those that are addicted."

The new legislation was signed before a gathering of local law enforcement, including Wells, Bradenton Police Chief Melanie Bevan, Palmetto Police Chief Scott Tyler, Holmes Beach Police Chief William Tokajer and Sarasota Sheriff Thomas Knight. Also present was the bill's sponsor, Rep. Jim Boyd, R-Bradenton.

"There's not a person in this room who doesn't have a family member or a friend of the family that hasn't been affected by this epidemic," Boyd said. "This is another step to curbing this epidemic."

Since the indictment of at least 34 drug dealers on federal charges during Operation Hot Batch, announced in December, suspected fatal and non-fatal overdoses have been on the decline in Manatee County.

The Manatee County Sheriff's Office has investigated 47 suspected overdoses in the first two months of 2018, compared to 172 suspected overdoses in the first two months of last year. There have been six suspected fatal overdoses during the first two months of 2018, compared to 21 during the same period.

Wells said by charging those drug dealers in federal court, law enforcement could charge dealers adequately for them to receive a just sentence, since a new state law had not yet taken effect.

HB 477, which went into effect Oct. 1, now enables drug dealers selling fentanyl or synthetic forms of the lethal drug to be charged with murder and trafficking, or face minimum mandatory prison sentences and fines.

"They were killing people down here, and they didn't care about it," Wells said.

Scott took time Monday to recognize law enforcement officers "who are at the front-line of this epidemic," and specifically Manatee sheriff's office Lt. Brady McCabe. Last year, McCabe was responding to a suspected overdose, and as he responded the woman stopped breathing. McCabe gave the woman a dose of naloxone that revived her shortly after paramedics arrived.

"I want to thank all the law officers that on top of keeping us safe from horrible things that are happening out there, they are also dealing with the drug addiction out there," Scott said.


Getting prescribed opioids

The new law, which will take effect July 1, will limit prescriptions for acute pain and hold those prescribing opioids more accountable.

Anyone who is prescribed a schedule II opioid, which includes Vicodin, Dilaudid, Demerol, OxyContin and fentanyl, for acute pain will only be prescribed a three-day supply, once the new law takes effect. If the prescriber feels more than a three-day supply is medically necessary, a seven-day supply can be prescribed. The prescription will need to say "acute pain exception" and the patient's record will need to include documentation of the acute condition and a lack of alternative treatment that justifies the seven-day supply.

"Is that an inconvenience? Yes," Florida House Speaker Richard Corcoran said after Scott signed the new law. "Is it an inconvenience that's worth saving 50,000 lives nationwide? Absolutely."

The new law will also require those healthcare providers prescribing or dispensing controlled substances to first check a patient's history in the Florida Prescription Drug Monitoring Program. Penalties are also increased for those who provide drugs that are medically unnecessary under the new law.

"We knew that opioids were being prescribed in a reckless manner," Wells said.

About 80 to 85 percent of those dealing with heroin or fentanyl addiction began with a legal prescription for a minor medical procedure, the sheriff said. To truly attack the epidemic, that needs to monitored and controlled. And those already addicted need long-term treatment so they don't revert to pills.

"Funding needs to be available for long-term treatment," Wells said. "Just a 12-step program is not going to work when you are dealing with an opioid addiction. It's just too strong. We have to make sure we are able to fund treatment and mental illness providers properly."

Ultimately, Wells said the most important thing will be for treatment centers to get the funding they need, and he is counting on the governor and lawmakers to deliver the money promised.

"They need more beds. We need more of them. Right now, we are having to send people to Sarasota, to Tampa ... as far as Miami and Colorado," Wells said.


Funding breakdown

Here's how the funding included in the new law is broken down:

--  More than $27 million in federal funding from the Opioid State Targeted Response Grant appropriated to the Florida Department of Children and Families. This grant was the second year of money promised under the 21st Century Cures Act through the U.S. Department of Health and Human Services grant program.

--  More than $14.6 million yearly for enhancements to the substance abuse system of care given to the Florida Department of Children and Families for community-based services, including additional residential treatment beds, outpatient treatment and case management, emergency room treatment and follow-up, peer recovery support services and targeted outreach for pregnant women with substance abuse disorders.

--  $5 million yearly to the Florida Department of Health to provide naloxone for first responders.

--  $6 million yearly to the Office of State Court Administrator for medication-assisted treatment for opioid addiction.

-- More than $990,000 to enhance the Florida Prescription Drug Monitoring System. The system will receive $873,000 a year in subsequent years.

(c)2018 The Bradenton Herald (Bradenton, Fla.)

Caroline Cournoyer is GOVERNING's senior web editor.
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