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Executive order to limit initial opioid prescriptions to 5 days

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An executive order issued today by S.C. Gov. Henry McMaster will limit state Medicaid and Public Employee Benefit Authority recipients to five-day initial prescriptions for acute and post-operative pain medications.

The executive order came as part of a declaration of a statewide opioid public health emergency. The declaration allows state officials to use emergency management resources like those normally called upon in a natural disaster to combat the opioid epidemic.

The governor directed the S.C. Department of Health and Human Services to limit all initial opioid prescriptions to a maximum of five days for state Medicaid recipients. At the governor’s request, PEBA agreed to enact similar restrictions for state health plan participants. McMaster asked the General Assembly to pass legislation making the five-day limitation state law.

“The opioid crisis is one that has invaded so many aspects of the lives of South Carolinians and of families across the country,” McMaster said in a statement. "We are confident that if there is a group capable of combating this problem, providing treatment for those affected, and bringing about tangible results that will change lives, it’s this group of dedicated, talented individuals that we have been able to put together.”

A second executive order established the Opioid Emergency Response Team, led by State Law Enforcement Division chief Mark Keel and Department of Alcohol and Other Drug Abuse Services interim director Sara Goldsby. S.C. Adjutant General Robert Livingston will also have a role in the response team, which will also include representatives from state and federal law enforcement, state health and regulatory agencies and health care treatment providers.

“Unfortunately, we know that we have not yet reached the peak of the opioid crisis,” Goldsby said. “While our work in South Carolina is urgent and ongoing, cross-sector coordination is key to comprehensively addressing this public health crisis and its related consequences.”

The response team will hold monthly meetings, beginning Tuesday, for the next six months to evaluate information and develop strategic plans.

“One piece of the puzzle I hope to bring to the table is us not losing the humanitarian aspect,” said Rep. Eric Bedingfield, R-Greenville, chairman of the S.C. House Opioid Abuse Prevention Study Committee. “My family is just one of the more than 600 in South Carolina who have lost loved ones as a result of this epidemic. These people who find themselves addicted are not morally corrupt individuals. These are people who have a disease and who need help.”

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December 20, 2017

While I fully appreciate the magnitude of the opioid addiction problem in the U.S. limiting the initial prescription to 5 days may put an unfair burden on the poor and the elderly for several reasons: 1) each filling of a prescription carries with it a copay; these copays can add up to quite a bit of money. 2) to obtain a new prescription, the patient may have to revisit the office or ask to have a new prescription written. Again, both of these may carry financial charges. 3) transportation; those who are ill or infirm may have difficulty getting to a pharmacy to pick up a refill. I hope that we will address the opioid crisis through measures that are not knee-jerk reactions but well thought-out strategies. We need to make the prescribing medical person more accountable. Each prescriber needs to have an up-to-date way to find out what the patient is currently being prescribed from all prescribers. Don't make it more difficult for the poor and elderly to get the medications they need. Sincerely, Deborah Fox Greer, SC