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S.C. lawmakers asked to change bill that would limit first opioid prescription to five days

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James O'Leary

James O'Leary, the former president of the South Carolina Orthopedic Association, asked state lawmakers to reconsider a bill that would limit initial prescriptions for pain pills to five days. Staff/Andrew Brown 

COLUMBIA — South Carolina lawmakers seeking to curb the over-prescribing of pain pills were setback Wednesday, as a medical group asked state officials to rethink an initial five-day limit on the highly-addictive drugs.

The debate over how many prescription pills a physician can prescribe to patients immediately after a surgery coincides with state leaders' attempts to combat a deadly opioid epidemic that killed at least 616 South Carolinians and more than 64,000 people nationwide in 2016. 

Lawmakers in the Statehouse are particularly focused on pain pills that are sold under brand names like OxyContin, Percocet and Vicodin because the overuse of those legal prescriptions is shown to lead to opioid addiction and, in some cases, the illicit use of heroin. 

The bill to limit patients' initial post-surgery prescriptions to five days is part of a larger package of legislation drafted by a special House committee that studied the deadly epidemic over the past year.

During a hearing Wednesday, a panel of lawmakers delayed a vote on that bill in order to address concerns among members of the South Carolina Orthopedic Association. They did, however, advance another bill that limits a single prescription of narcotics to 120 pills.  

James O'Leary, the association's former president who practices in Columbia, told lawmakers that he was concerned a five-day cap on first-time prescriptions after surgery would be painful and hassling for his patients.

O'Leary recognized why lawmakers were taking action to control prescribing patterns for the highly addictive drugs, and told lawmakers that his office consistently uses a statewide database that allows doctors to monitor people's prescriptions. 

But O'Leary told lawmakers an initial five-day prescription wasn't enough for people who receive knee surgeries or other procedures at his office. He said many have severe pain for at least a week, and that very few stop taking pain medication before seven days. 

"Our patients do need narcotics. Five days just doesn't work," O'Leary said. "It's just very problematic for the patients." 

The bill exempts prescriptions for cancer, hospice and palliative care patients. It also allows people dealing with chronic pain or those undertaking medication-assisted treatment for addiction to get the prescriptions they need. 

O'Leary asked lawmakers to consider similar exemptions for orthopedic surgeons, like himself. They need some flexibility in the law, he said. Most doctors are already doing everything they can to stop over-prescribing the narcotics, he said.

"The pendulum has swung in the right direction. I promise you," O'Leary said. "Everyone is doing the best they can to not throw gasoline on this fire." 

Rep. Robert Ridgeway, a Democrat from Manning who is a practicing physician, agreed with O'Leary. The problem, he said, was the training doctors received in past decades regarding pain management and prescribing. 

"I think this is an education issue that not only affects providers but it affects the patients and the general public," Ridgeway said. 

The bill isn't expected to be considered again until March. 

Reach Andrew Brown at 843-708-1830 or follow him on Twitter @andy_ed_brown.

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