New Jersey just passed one of the nation’s most comprehensive laws to combat the growing opioid and heroin crisis.
The law will reduce the supply of drugs that patients getting their first opioid prescription can get from 30 days to five days. It also will require doctors to talk to patients about how addictive the drugs are. For addicts whose doctors have recommended treatment, the law also mandates that insurers offer 180 days of coverage without preauthorization.
“We’re starting to treat substance abuse like the chronic disease that it is,” said Cynthia Reilly, the director of Pew Charitable Trusts' substance use prevention and treatment program, about the law. “We don’t treat someone for diabetes for a few weeks and then expect them to be cured and stop treatment.”
The bill received unanimous, bipartisan support in the Senate with a 33-0 vote on Monday and overwhelming support in the House today with a 64-1 vote (there were five abstentions). New Jersey Gov. Chris Christie signed the bill into law after calling for the legislation in his State of the State address in January.
New Jersey’s legislation is part of a larger national trend of states getting tougher on opioid prescriptions
The Centers for Disease Control and Prevention estimates that since 1999, 165,000 people have died from overdoses linked to prescription opioid abuse and that as many as 40 Americans die each day.
And since much of the problem is due to too many opioids being prescribed and sold, the agency issued a set of guidelines last March that recommended prescribers limit initial opioid prescriptions to seven days or less. Massachusetts became the first state to enact the CDC’s guidelines, passing a law that restricted opioid prescriptions to a seven-day supply.
Eight other states in the Northeast (including New Jersey) have followed suit and passed their own legislation, as you can see in the map below. In Arizona, Gov. Doug Ducey (R) mandated a seven-day restriction on opioid prescriptions through executive order.
Normally, public health is politically polarizing. But Republicans and Democrats are united on curtailing opioid abuse.
Of the 10 states with prescription limits, six are led by a Republican governor and four by a Democratic governor. What’s more, in a state like Massachusetts, where the governor is Republican and the state legislature is majority Democrat, they achieved not just consensus but unanimous consensus.
This kind of widespread bipartisanship support isn’t a given in public health. But the opioid problem has emerged as one of the very few health issues members of both parties are rallying around these days.
In early 2014, researchers polled US adults on their thoughts about opioid abuse. They wanted to know if Americans thought it was a serious issue and which, if any, policy solutions they supported to combat it.
It turned out that Americans on both sides of the political aisle thought opioid abuse was a serious problem, and of 16 possible policy solutions — ranging from stricter regulation of pharmaceutical companies to expanded Medicaid benefits — there was bipartisan support for all but two proposals.
The reason? People from both parties are equally likely to have known someone who has abused prescription painkillers.
The sobering reality, according to Robert Blendon, a professor at Harvard’s School of Public Health who has studied public opinion around opioids, is that the opioid epidemic is so widespread in the US that it cuts across demographics, class divisions, and even political parties.
And even though certain areas of the country are harder hit than others (as you can see in the map below), researchers found that Democrats and Republicans are equally likely to consider opioid addiction to be a serious problem in their state.
People living in rural areas of the US are more likely to have known someone who abused opioids than people in urban areas. But “there is a high incidence of death from opioids in both white, rural Republican areas and low-income areas in cities,” said Blendon. And so urban Americans are just as likely as rural Americans to think that opioid addiction in the US is a serious problem.
What’s more, Blendon argues that the type of proposed government intervention around opioid abuse is particularly conducive to bipartisan support because it is limited in reach — no federally managed oversight, just policy solutions focused on bolstering existing state-run programs.
The Comprehensive Addiction and Recovery Act (CARA), which authorized $181 million annually to fight the opioid epidemic, passed in the summer of 2016 with almost unanimous support (94-1 in the Senate and 400-5 in the House).
“It’s a matter of both who’s affected by it and the nature of the government intervention,” Blendon said. “We’re not talking about 20 new federal laws, but rather state laws that will limit the ability of physicians to make certain types of prescriptions. It’s not the federal government running the opioid response.”
But researchers warn that if opioid addiction becomes politicized, or strongly associated with one of the two political parties, policy adoption will become more challenging.
“If this becomes an issue where politicians are competing for the best way to deal with opioids, we will see polarization emerge,” said Sarah Gollust, a professor of health policy at the University of Minnesota who studies how public opinion shapes public health. “But [the opioid epidemic] is also different in a lot of ways. It’s more common among white Americans, and that changes the questions about deservingness and groups.”