Curtis’ Non-Opioid Directive Act Aims To Combat Opioid Addiction By Giving Control To Patients
Rep. John Curtis, R-UT, has introduced legislation to give patients more control over their pain treatment. It comes as Utah has seen an increase in opioid-related deaths since the start of the pandemic.
Curtis said the act was also prompted by his own experience last year when he underwent several surgeries.
“It was amazing medical care,” he said. “But I had expressed when I went into the hospital that I didn't want opioids, and yet I walked away after surgery with a bag full of opioids.”
Curtis said he introduced the Non-Opioid Directive Act as a way to establish clear communication between patients and healthcare workers from the very beginning of their care. If passed, it would require health insurance companies and the Department of Health and Human Services to provide a directive form to patients.
The directive would let patients specify in their medical records they don't want opioids as part of their treatment plan.
Curtis said people often come in contact with several healthcare providers and they are not always up to date with the patient’s preferences. He said he sees this act as a way to facilitate discussions around care and preventing addiction.
“My guess is, in my case, that the prescribing physician never saw or never heard that information, that was my preference,” Curtis said, “and I think had they seen that they [would] have been able to sit down with me and say, ‘OK, let's talk about that. Let's talk about pain management.’”
Curtis also said it's a delicate balance between the role of lawmakers, physicians and patients.
“We all have a role in this, but we all have to respect each other's role,” he said. “Lawmakers need to realize that physicians understand the true needs of their patients.”
Dr. Shane Brogan, a pain physician with the Huntsman Cancer Institute, works with cancer patients and people who deal with chronic pain.
Brogan said the bill has good intentions but doesn’t offer real solutions to this issue. He said he wants to see legislation that would make it easier to access other pain treatment options — like physical therapy or acupuncture.
“We have a lot of difficulty with insurance companies paying for non-opioid pain medicines,” Brogan said. “Oftentimes [they] are much more supportive of prescribing opioid medications. My nurses spend half their day sometimes trying to get non-opioid medications covered by health insurance.”
In recent years, states like Delaware have passed legislation prohibiting insurance companies from limiting the number of times a patient can go to physical therapy or chiropractic care. Their goal is to curb the use of opioids.
Brogan said he also worries this bill could create more stigma around opioids — which can be an important option for patients dealing with severe pain.
“I know there's a major problem out there,'' he said, “But I spend a lot of time reassuring patients that it's ‘OK, you can take this medicine. You're doing it in a safe context.’”
Brogan said pain treatment can be a complicated issue. He agrees with Curtis that it is important to have conversations with providers about the best practices for care.