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Opioid regulations headed to next step after Board of Medical Licensure approval

The Mississippi Board of Medical Licensure debates new regulations on the prescription of opoids. Photo by Steve Wilson

The Mississippi Board of Medical Licensure approved updated regulations at its meeting Friday that could change the way doctors in the state prescribe opioid pain medications and possibly end the practice of telemedicine.

The regulations are headed to the secretary of state and to the state's new Occupational Licensing Board, which was created by legislation last year and meets quarterly. If the secretary of state and occupational licensing board approve the new regulations in the next two to three months, they will put more stringent restrictions on how Mississippi doctors can prescribe addictive opioid medications for pain.

The regulations would put a crimp on telemedicine in the Magnolia State since prescribing medication would require a physical examination by a doctor. Telemedicine is the practice of using video conferencing or a phone call to provide health care and consultation.

State Rep. Joel Bomgar (R-Madison) has analyzed data from the U.S. Centers for Disease Control and says that putting restrictions on opioid prescriptions without treatment options could lead to addicts turning to street drugs such as heroin and increasing the number of overdose deaths.

"I think on the whole, we're in the top 10 for prescriptions and we're in the bottom ten of the 50 states for overdose deaths," Bomgar told the board. "It's still unavoidable, on net, that this will move us up the ladder from the bottom ten and more people will die unless the other states are making changes like we are that are faster or more aggressive that will keep us in the bottom ten.

"The net takeaway is that it will bring our prescriber rate down, but will bring our death rate up."

Board member Dr. Randy Easterling disagreed strenuously with Bomgar's comments.

"I want to make it clear for the record that what you (Bomgar) said about hundreds dying is simply your uneducated opinion," Easterling said. "You're not a physician, you're not an addictionologist, you're not a pain management specialist and you derive this from data, which you're a lot better at this than I am.

"The number of deaths reported in states is grossly unreported, so over time you're going to see death rates go up, not because of what you said in my opinion, but because we're going to do a better job of reporting it."

Under the new regulations, doctors will have limits on how much opioids they can supply patients in a certain time period and will face heightened scrutiny from regulators over prescribing them in conjunction with benzodiazepines, which are used to treat anxiety and other mental issues. Xanax is an example of a benzodiazepine. Doctors will also have to keep more detailed records on patients with opioid prescriptions for acute, non cancer-caused pain.

Patients would also be screened for other drug use by the doctor each time a new prescription is written under the new regulations. Fred Ingram, a gynecologist who practices in Jackson, told the board that the drug testing regime in the new regulations would hurt patients since Medicaid doesn't pay for drug tests.

Gov. Phil Bryant's Opioid and Heroin Study Task Force recommended some similar measures in its report filed in August.

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