As Overdose Deaths Climb, Pain Patients and Doctors React to Proposed Restrictions

Originally published on February 14, 2018 1:19 pm

The State Medical Board wants to tighten restrictions on doctors’ abilities to prescribe opioids in some instances, and one of the changes is that patients will be asked for a urine sample for drug testing.


Arkansas has the second-highest opioid prescription rate nationwide, according to the Centers for Disease Control and Prevention, and the proposed regulations are part of an effort to combat the deadly overdose crisis in the state.

Arkansas Drug Director Kirk Lane told the medical board at a hearing for public comments Thursday that opioid abuse, particularly heroin use, is going up, and overdoses are increasing.

“Yesterday, I started my day with two phone calls. One, recognizing the passing of a 20-year-old individual...to an overdose. The second call, within a matter of minutes, was from a neighboring coroner that they had worked four overdose deaths in the last 36 hours,” he said.

The new rules require urine samples from patients to test for illegal drug use. Opioids, which are typically painkillers that are synthetic versions of the narcotic opium, will still be allowed for chronic pain treatment, but only after a consultation with a pain management specialist (not just any family doctor or prescribing health professional) and a signed agreement about the risks of taking the drugs.

Such proposed new practices would have to be approved by the Arkansas legislature.


Lane asked the board to consider shortening its proposed seven-day cap on opioid prescriptions for acute or emergency pain treatment to five days, like a number of other states.  


“I think it’s important that we look at other states, because other states are seeing this problem more quickly than we have. We’re now just seeing how heroin and the opioid dependency of our state is affecting heroin [use rates] and affecting mortality.”


Joe Phillips, a Conway resident who says he takes oxycontin and hydrocodone for a 20-year-old back injury

“All of a sudden, 'Well we're going to take your medicine away,' is basically what they are saying," said Phillips. "I’ve lived a productive life and I’m not willing to go down without fighting. I mean, I’m an active person, I don’t sit around the house."


Phillips was one of several people who told the board that their physicians are dialing down their long-standing opioid prescriptions out of fear of the new regulations.


“Well, it’s my quality of life. I mean, if I were to not take my medication I would not be able to function, I would not be able to work, I would not be able to enjoy my grandkids, and we wouldn’t be able to go do things, and I mean, it would just basically be living a dull and flat existence,” said Phillips.


Members of the board reassured him and others that the proposed rules allow for opioids to be used for chronic pain, and that they will work to better educate doctors about the changes.


Several physicians told the board that pain management doctors who operate without full credentials are more likely to over-prescribe opioids. They asked that the rules define who is qualified to treat pain.


A former dean at the University of Arkansas for Medical Sciences, Richard Smith, urged the board and the medical community to come together to address the growing crisis before the state legislature does.


“If we don’t all pull together and get a handle on this, I am afraid we are going to have very restrictive laws that are passed that limit our ability to take care of our patients.”


In 2016, the Centers for Disease Control and Prevention reported Arkansas’s prescription rate was more than 114 for 100 people, the nation’s second-highest rate behind Alabama.

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