How Walmart's Decision to Limit Opioid Prescriptions Could Affect U.S. Drug Abuse - Fortune

May 7, 2018

How Walmart's Decision to Limit Opioid Prescriptions Could Affect U.S. Drug Abuse

By NATASHA BACH 7:08 AM EDT
Walmart is expanding its Opioid Stewardship Initiative, introducing additional measures this week in an effort to further curb opioid abuse.

The retail giant announced Monday that it will begin limiting supplies of acute opioid prescriptions to no more than seven days, with up to a 60 morphine milligram equivalent maximum per day. The change will come into effect within the next 60 days, and will apply to all Walmart and Sam’s Club pharmacies in the U.S. and Puerto Rico.

Why Walmart is limiting prescriptions
Walmart’s new policy aligns with the Centers for Disease Control and Prevention’s (CDC) guidelines for opioid use. These guidelines suggest that clinicians should prescribe the “lowest effective dose” of opioids to treat pain, as its abuse often stems from such treatment. They should therefore prescribe “no greater quantity than needed,” which is often “three days or less” but “more than seven days will rarely be needed.” In states where the law for fills is less than seven days, Walmart and Sam’s Club will abide by this lower limit.

Why not all doctors agree
Many medical professionals are concerned that such limits could be arbitrary and prevent a doctor from addressing the individual needs of each patient. The American Medical Association (AMA) told The Hill that “Pain is a complex, biopsychosocial phenomenon, and individuals experience pain in different ways. The AMA believes that decisions around dosages needs to be left between the patient and the physician.”

What happens next
The issue is not at all black and white. Many have found that overprescribing is often a culprit, as it increases the amount of opioids in circulation, thereby increasing the potential for addiction. While a CDC study largely corroborates this argument, noting that someone prescribed eight or more days of an opioid therapy had a 13.5% chance of addiction within a year, the same study found that even a day of such a therapy already increased the risk of addiction by 6%.

Generally speaking, limiting access to opioid prescriptions may in fact decrease the risk of addiction and abuse. However, it is not immediately clear whether Walmart’s seven-day limit will be adequate to have a marked effect.