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Legislation Allows Hundreds of New Medical Providers to Prescribe Highly Addictive Opioids


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JUNEAU, AK - Amid Alaska’s spiraling opioid epidemic, the Alaska Senate passed legislation today that puts patient safety at risk by allowing as many as 125 of optometrists—who are not medical doctors or trained surgeons—to prescribe highly addictive narcotics and perform surgery on the eyes of Alaska patients.  " While we are in the midst of a national debate over our nations medical system, this bill is a bad idea,” said Griff Steiner, MD, a 4th generation Alaskan and ophthalmologist—a medical eye doctor and surgeon— who has been performing eye surgery in Anchorage for over 20 years.  “While trying to limit the amount of dangerous opioids on the street, House Bill 103 shockingly, and needlessly will add more than 100 new prescribers of these dangerous substances,” Steiner added.  “But perhaps more alarming provisions of this legislation is that it allows insufficiently-trained providers who are not even medical doctors to perform eye surgery,” said Scott Limstrom, president of the Alaska Society of Eye Physicians & Surgeons.

 
Allowing optometrists to perform surgery on the eye, and to prescribe opiates like Oxycontin appears contrary to Governor Bill Walker’s Emergency Order to battle the growing Alaska epidemic. Similar legislation was vetoed more than a decade ago by former governor Tony Knowles. 

 

In 2014, the Alaska State Legislature passed legislation to continue to allow optometrists to prescribe controlled substances containing Hydrocodone.  During consideration of this prescription authority, the legislature continued the four-day prescription limitation to protect patients. HB 103 would not only remove Hydrocodone and other controlled substances prescription time limitation, the optometric bill would also expand the controlled substances that optometrists would be authorized to prescribe to include all Schedule Ia and IIa controlled substances which are very powerful and highly addictive substances. 

“The AMA is concerned that authorizing optometrists to prescribe Schedule II Controlled Substances may undo important gains Alaska has made in reducing the state’s opioid supply as one component of reversing opioid-related overdose and death,” said James L. Madara, MD, AMA Executive Vice President and CEO. “From 2013 to 2016, Alaska physicians’ increased efforts to be more judicious when making prescribing decisions has caused a 13.3 percent drop in opioid prescriptions. This concerted effort by the physician community has made Alaska one of the lowest per capita opioid analgesic prescribing rates in the nation.  Unfortunately, opioid-related overdose and death are increasing in Alaska.  Now is not the time to increase the category of prescribers of Schedule II Controlled Substances and potentially add more opioids available for diversion and misuse.”
 
With approximately 125 licensed optometrists practicing statewide in Alaska, this bill will lead to a spike in the number of prescriptions, and consequently, the number of illicit users could grow along with it.  Optometrists, simply do not have the rigorous medical training that all M.D.’s receive to help recognize addictive or abusive drug behavior in patients.” 
 
The Alaska House of Representatives approved HB 103 on April 28th.  With the Senate’s action today, it now goes to the desk of Governor Walker.  The Alaska Society of Eye Physicians & Surgeons and others in the medical community will be urging him to veto the measure. 

 

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