In response to the surging opioid prescription rates by health care providers that contributed to the opioid epidemic in the United States, US states began passing legislation to stifle high-risk prescribing practices (such as prescribing high doses of opioids or prescribing opioids long-term). These new laws fell primarily into one of the following four categories:
Prescription Drug Monitoring Program (PDMP) enrollment laws: prescribers must enroll in their state's PDMP, an electronic database containing a record of all patients' controlled substance prescriptions PDMP query laws: prescribers must check the PDMP before prescribing an opioid Opioid prescribing cap laws: opioid prescriptions cannot exceed designated doses or durations Pill mill laws: pain clinics are closely regulated and monitored to minimize the prescription of opioids non-medically
Multi-state compact
In July 2016, governors from 45 US states and 3 territories entered into an interstate compact titled a "Compact to Fight Opioid Addiction" organized by Massachusetts Governor Charlie Baker where they agreed to adopt the strategies for addressing the opioid epidemic modeled after the policies implemented in Massachusetts. They agreed that collective action would be needed to end the opioid crisis, and they would coordinate their responses across all levels of government and the private sector, including opioid manufacturers and doctors.
Responses by state
Alabama
In 2017 Alabama had the highest overall opioid prescribing rate in the US. The University of Alabama – Birmingham has made a commitment to battle the opioid epidemic. UAB's "Addiction Scholars Program" trains health care professionals - doctors, nurses, therapists, and social workers with insights into addiction in a 15-month course. The UAB School of Nursing offers "Nursing Competency Suites" with training on treating infants born to opioid-addicted mothers. The university also began an "Opioid Stewardship Committee" to "…consistently and frequently address opioid stewardship."
Opioid data for Alabama indicated that, from 2006 to 2014 2.3 billion pain pills were prescribed in the state. McKesson Corporation distributed 728 million of these pain pills; Par Pharmaceutical manufactured 713 million. The highest number of the pills went to Senior Care Pharmacy in Northport AL.
Arizona
Arizona's Governor Doug Ducey signed the Arizona Opioid Epidemic Act on January 26, 2018, to confront the state's opioid crisis. In Maricopa County which includes Phoenix, 3,114 overdoses were reported from June 15, 2017, through January 11, 2018. The law provides $10million for treatment and limits an initial opioid prescription to five days with some exemptions. Arizona also implemented a new strategy of prescription drug monitoring programs in 2017. Since then, the number of opioid prescriptions filled has dropped nearly forty percent, while the number of opioid prescriptions written has dropped forty-three percent (King, 2018). The reductions in these numbers both show Arizona going in the right direction, although, even with the decrease, the number of deaths and overdoses continue to rise.
Arkansas
In October 2016, the state began the Arkansas Naloxone Project, a partnership of the State Drug Director's Office, DHS, and the Criminal Justice Institute (CJI) to allocate kits containing the nasal spray naloxone to first responders, schools, libraries, as well as drug treatment and recovery agencies to reverse the effects of opioid overdose. The project, funded by federal grants and the Arkansas Blue & You Foundation, distributed 7,000 kits and provided training to 8,000 individuals. Additionally, the Drug Director's Office and the CJI developed an app, nARcansas, a free opioid overdose training vehicle that shows how to administer the life-saving antidote and provide other information about opioids and overdoses, in both English or Spanish versions. The project has saved lives in almost half of Arkansas' 75 counties, with the most success in Pulaski County, the state's most populated.