Bill aimed at combating addiction could limit opioid prescriptions

OLYMPIA — Patrick Janicki was 20 when he fell while pole climbing at a county fair, suffering a severe back-injury. After years of managing chronic pain from the injury, Patrick told his mother in 2016 that he was addicted to pain pills.

Patrick was 30 when he died of health complications related to his drug use, less than a year after telling his mother he was addicted.

Lisa Janicki, Patrick’s mother and a commissioner for Skagit County, traveled to Olympia Friday to ask the House Health Care & Wellness Committee to vote for HB 2272, which would place restrictions on opioid prescriptions.

HB 2272 and its companion bill, SB 6050, were requested by Attorney General Bob Ferguson to combat opioid abuse. If enacted, medical practitioners could issue no more than a seven-day supply of opioids for patients who are 21 years or older, or more than a three-day supply for patients younger than 21.

Practitioners would still have discretion to prescribe their patients a greater supply of opioids if deemed necessary, but for no longer than a patient’s pain is severe enough to need opioids. The condition requiring more opioids would be documented on the patient’s medical record.

Cancer patients and those receiving end-of-life care would be exempted from these prescription limitations.

Patrick had been under the care of the family’s physician for years, who Lisa said had been recklessly prescribing powerful and long-lasting opioids to her son and contributing to his addiction. These included fentanyl patches, which are effective for 72 hours and potent enough to kill patients not already tolerant to opioids.

Under the proposal, practitioners would also be required to discuss the risk of addiction with patients prescribed more than a three-day supply.

Janicki asked the committee to take these regulatory steps to help save the lives of people like Patrick.

“I could not save my own son, but I want to make darn certain we save someone else’s kid,” Janicki said.

Janicki was one of several members of the public who spoke about loved ones lost or nearly lost to opioid addiction.

Among those who began using in the 2000s, 75 percent of opioid abusers reported that their chronic use started with a prescription drug, according to a 2014 study by the National Institute on Drug Abuse.

Patients who initially received only a single day’s supply of prescriptions had a 6 percent chance still to be using opioids a year later, according to a 2017 study by the Centers for Disease Control and Prevention. Patients were more than twice as likely to be using opioids a year later if their initial prescription lasted eight days or longer. Prescriptions of long-acting opioids resulted in the highest rates of long-term use.

While everyone in the hearing room agreed that opioid-related deaths were tragic, there was disagreement that the attorney general’s bill was the right solution.

Rep. Michelle Caldier, R-Port Orchard, questioned why the legislation would focus on days of supply, rather than the quantity or concentration of opioids prescribed for that duration.

Nathan Schlicher, a representative for the Washington State Medical Association, agreed that focusing on days and not on pills was problematic. Schlicher said the restrictions would drive doctors concerned with patient pain to prescribe more and stronger pills.

Rep. Drew MacEwen, R-Union, raised concerns about the inconvenience to patients who would need to drive to their practitioner every three to seven days in order to get another prescription.

Testifying for his bill, Ferguson said that the benefits of mitigating opioid abuse outweigh the potential inconvenience.

“I have three words,” Ferguson said. “People are dying.”