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Addiction to prescription opioid painkillers has reached the level of a public health crisis. According to the U.S. Department of Health and Human Services, 11.5 million people misuse prescription opioids, with 2.1 million Americans misusing them for the first time each year. A recent survey of farmers and farm workers revealed the magnitude of the problem in the agriculture community, as 74% surveyed reported having been directly impacted by opioid abuse. Annually, the opioid epidemic costs the national economy $504 Billion. Nebraska has seen a 25% increase in the rate of death due to opioid overdose since 2005.
Prescription painkiller addiction begins with a health care provider prescribing opioid painkillers to a patient. Although highly effective at managing pain, these medications have a high addictive potential if not used judiciously and patients are not carefully monitored. An International Narcotics Control Board report found that the United States consumed 83% of the global use of oxycodone despite being less than 5% of the global population. Each year 650,000 opioid prescriptions are dispensed every day.
Diversion of prescription painkillers is the use of medication by someone other than for whom they were prescribed. This may be the use of unused opioids by a family member, the theft of medications, the sale of pills, or, in some cases, the diversion of a prescription to an addict who has the prescription filled and takes receipt of the medication.
The aforementioned survey of farmers and farm workers, more than 3 of 4 respondents said it would easy to access a large amount of prescription opioids in their community without directly obtaining a prescription from a doctor. In order to address the diversion component of the opioid epidemic, I have introduced LB 934. In order to reduce the potential for dispensing controlled substances to individuals who may abuse them, LB 934 requires an individual who takes receipt of Schedule II-IV opiates to show a photo identification.
Twenty-five states have identification laws for the receipt of prescription drugs. While Oregon’s law is discretionary, the other twenty four states have at least one law that mandates the pharmacist request identification. Identification requirements have been utilized before as a tool to combat drug addiction. Current federal and Nebraska state law require identification for the purchase of over the counter products containing ephedrine, including Sudafed. You cannot receive a shipment of wine purchased legally to your home without providing ID when delivered. It only makes sense that positive identification should be required before being handed a bottle of highly addictive controlled substances.
Throughout my time in the Nebraska Legislature I have collaborated with my colleagues to provide options for our state to address the problem of prescription opioid abuse. Nebraska’s Prescription Drug Monitoring Program is now a national model. During this legislative session, my fellow senators and collaborators have introduced additional bills to tackle the crisis. Senator Sara Howard has introduced a prescription limit for opiates prescribed to children. Senator Brett Lindstrom’s bill requires patient education about opioid addiction when being prescribed painkillers. Senator Merv Riepe has proposed continuing education requirements for practitioners who prescribe opiates.
Collectively, the bills represent a package of legislation that builds upon a multi-year legislative effort to proactively get in front of the prescription painkiller problem. Fortunately, Nebraska has not experienced the same magnitude of crisis as other states. Through cooperation and common sense, we can confront this public health issue head on.