MMA Testifies on Proposed Opioid Legislation

MMA Immediate Past President David Thorson, MD, told the House Health and Human Services Reform Committee that the MMA supports several of the initiatives aimed at addressing the state’s opioid epidemic, but continues to believe that mandating prescribers’ use of the state’s Prescription Monitoring Program (PMP) is problematic. 

Thorson’s testimony came on Feb. 21, which was Opioid Awareness Day at the Minnesota Capitol. Several opioid-related proposals authored by Rep. Dave Baker (R-Willmar), were considered including HF1137, which calls for mandatory use of the PMP by prescribers. 
  Dave Thorson, MD, a family physician in White Bear Lake, testified for the MMA on Dec. 21.

The MMA supports requiring prescribers to register for the PMP and has been working to encourage physicians to use the tool. “As a family physician, I use the PMP and it has been a great tool to help me determine if a patient has been receiving opioids from multiple sources,” Thorson testified. “But the PMP is not the easiest tool to use.”  

To address some of the concerns raised by the MMA, Baker amended the bill to limit the requirement to check the PMP to initial opioid prescriptions, not all controlled substances. Other exceptions to checking the PMP would include:  
•    when prescribing or dispensing to a hospice patient  or any other patient who has been diagnosed as terminally ill, or for the treatment of cancer
•    during an emergency or in an ambulance 
•    for a patient admitted to a hospital if, within 12 hours of admission, the prescriber or dispenser reviews the patient's controlled substance prescription record and a record of the review and any pertinent information is in the patient's records during the patient's stay in the facility
•    to treat acute pain resulting from a surgical or other invasive procedure or a delivery if it is for a 30 day or less supply, or
•    when the PMP cannot be accessed due to a technological or electrical failure, in which case the prescriber or dispenser shall document in the patient's record the reason the review was not completed.

Thorson explained to the committee that the ultimate goal should be to embed the PMP into the patient’s medical record to remove the administrative burden of the PMP. “When the PMP is working well, it will still take between three to five minutes to access it during my patient visit. That is when it is working well,” Thorson said.

Thorson noted that there is a paradigm shift in the treatment and management of pain occurring, and health care workers need to move their focus to changing the culture of how pain is treated, and ensure that those with addiction have access to treatment. “We must also continue to ensure appropriate access to opioid therapy for patients with active cancer, and patients receiving palliative or hospice care,” he said. 

The most effective way to change prescriber behavior is through peer-to-peer education, Thorson stressed. The MMA has been working with the Steve Rummler Hope Foundation and the University of Minnesota Medical School to develop a series of more than 20 education sessions for prescribers. 

While the MMA still has concerns with mandating the use of the PMP, Thorson expressed a desire to continue to work with Baker: “The MMA is committed to working with Rep. Baker going forward to address the remaining concerns to find effective solutions to address the addiction, abuse, and diversion of opioids in Minnesota.”