Many in the chronic pain community expressed concern after CVS pharmacy announced this month that it will limit opioid prescriptions to seven days for acute or new conditions. The wording of the new policy is as follows: “This program will include limiting to seven days the supply of opioids dispensed for certain acute prescriptions for patients who are new to therapy,” which means people living with chronic pain should not be subjected to the seven-day limit. However, CVS will limit the daily dosage of opioids and will require use of immediate-release formulations before prescribing extended-release opioids; these two changes may affect chronic pain patients.
“We are on board with limiting new prescriptions for acute pain, but we do believe there should be a specific, written exemption for chronic pain, palliative pain, and cancer pain in order to ensure they are protected,” says Paul Gileno, founder and president of U.S. Pain Foundation. “We agree that certain changes are necessary to end the opioid crisis, but we need to approach it in a way that considers the needs of chronic pain patients.”
He went on to address the dosage limit. “We are weary of a pharmacy entity, rather than a doctor, determining the dosage of an individual’s pain medication. Everyone is different–their body chemistries and weights, their level of pain, reaction to pain and so on and these can affect how much medication they need. That specific type of decision should be left in the hands of clinicians.”
“A number of states, including Massachusetts, have adopted laws limiting first-time opioid prescription to seven days, and this part of the new CVS policy is consistent with these restrictions” adds Cindy Steinberg, U.S. Pain’s national director of Policy and Advocacy. “We are in agreement with this limit for new, acute conditions; however instituting dosage limits for all patients is troubling. At the end of the day, we just want to make sure chronic pain patients aren’t facing unnecessary, unfair roadblocks to pain relief.”
CVS pharmacy locations also will increase education for patients filling an opioid prescription, expand its drug disposal collection program, and invest $2 million in addiction treatment.
“We are 100 percent supportive of more education and increased efforts to prevent diversion,” says Gileno. “We are encouraged that CVS is including these steps in their new policy, and hope to be part of a larger discussion on how to ensure patients with pain are protected too. We have a lot of ideas for ways to safely and fairly address the opioid crisis, from increasing the availability of abuse-deterrent formularies to legalizing medical cannabis. We just need someone to listen.”
To read U.S. Pain’s full position statement on opioids and balancing reform with pain management, click here.