The opioid epidemic is no stranger to Florida. In 2016, there were 2,798 reported opioid-related overdose deaths in the state, a rate of 14.4 deaths per 100,000 persons. The national average is 13.3 deaths per 100,000.[1] While there is no single fix to the opioid epidemic, states across the country have employed various approaches and Florida is no different. During the 2018 legislative session, the Florida legislature passed HB 21 a comprehensive opioid bill.
The majority of the 203-page bill applies directly to health care providers and the use of opioid medications. There are four key provisions of the new law that consumers and injured workers will mostly likely feel the effects of: prescribing guidelines, fill limits for acute pain treatment, access to opioid antagonists, and requirements for picking up a prescription.
One of the first impacts for injured worker is the requirement that prescribers rely on prescribing guidelines when using opioids. Medical boards across the state are currently drafting and implementing these prescribing guidelines, but we know they will require the development of an opioid treatment plan, periodic reviews of the patient and the plan, and consent from the patient about the risks of overdose and abuse associated with opioids. While the obligations fall on the provider to follow these guidelines, injured workers may carry some of the burden as well. Treatment plans would address how they take the medications, what goals they should be obtaining, and potentially subject the injured worker to periodic drug testing.
The use of opioids for acute pain, or pain that is time-limited, will be limited to a 3-day supply. In some scenarios, the use of a 7-day supply may be allowed if medically necessary. As in other states that have adopted fill limits, the goal is to ensure that opioids are not overused, leading to addiction, or overprescribed, leaving unused pills in circulation for illicit use. Under this new law, when injured workers seek treatment following an injury, they will likely be limited to a 3-day supply of an opioid, as most initial injuries are acute pain. A question that remains outstanding is how a patient would receive an additional prescription after the 3-day supply. It is likely the requirements on this will be part of the prescribing guidelines and will likely require the injured worker to meet with their provider again to determine if an additional script is warranted. It’s important to note the acute pain limitation does not include traumatic injuries or cancer treatment.
When an injured worker receives their opioid prescription, they will also notice a change. First, when picking up a prescription for a controlled substance an injured worker may be asked to present their photo ID or to otherwise prove their identity. This is a requirement on pharmacists to ensure they are dispensing the prescription to the right individual. Pharmacies, including a home delivery pharmacy, may also verify the identity of the patient in other ways, such as contacting the prescriber. Additionally, if an injured worker is receiving the opioid for a severe injury, they’ll also notice an accompanying prescription for an opioid antagonist, like Naloxone. This additional prescription accompanies opioid scripts with higher dosages and longer lengths of use, ensuring access to this lifesaving medication in emergency situations.
With the introduction and passage of HB 21, Florida has taken significant steps to combat the opioid epidemic. As these changes are implemented we will better understand how they impact the injured worker and if they are able to help Florida turn the tide on the opioid epidemic.
Danielle Jaffee
Director of Legal & Government Affairs, Injured Workers Pharmacy
Injured Workers Pharmacy (IWP) is a specialized workers’ compensation home delivery pharmacy that helps injured workers access their prescription medications without delays, denials, or out-of-pocket costs. To learn more about IWP, visit their website at www.IWPharmacy.com.
[1] https://www.drugabuse.gov/drugs-abuse/opioids/opioid-summaries-by-state/florida-opioid-summary