Georgia Bill SB 81

Georgia recently tried to restrict schedule II-and-higher prescription drugs (schedule I is already illegal to prescribe).  The internet reported this as “requiring ADHD patients to get a new prescription every five days” and yelled a lot because you are literally requiring extensive logistical work to treat a medical condition defined as being bad at planning and follow through (not to mention the money).  Georgia made some changes, which were reported as “ADHD prescription rule removed from bill, restrictions now focus on opioids”.

Reading the text of the bill (unclear if this is the draft either news article was talking about), neither of these appear to be accurate.  The bill doesn’t actually ban longer prescriptions, just leaves open the option to sue providers if they don’t either check a statewide database of prescriptions, or give a restricted supply.  Even then the 5 day rule only applied to the first prescription for adults (although every prescription for children) (line 275).  If you think the government should be in the business of restricting access to certain drugs in the first place (which I don’t), requiring doctors to make sure you don’t already have a prescription seems totally reasonable.  And they explicitly said prescribers should prescribe whatever was in the patients’ best interests, they just needed to note the justification for a new prescription of longer than 5 days.

Well, kind of.  The full text is “Nothing in this paragraph shall limit a prescriber who, in his or her professional 289 medical judgment, determines that more than a five-day supply of a Schedule II, III, IV, 290 or V controlled substance is medically necessary for palliative care or to treat a patient’s 291 acute medical condition, chronic pain, or pain associated with a cancer diagnosis.” (line 288).  This leaves out anyone with a chronic condition that isn’t pain that requires scheduled drugs.  This includes ADHD, but also sleep disorders, anxiety requiring benzodiazepines, epilepsy, being a trans man, and diarrhea.

[Controlling anti-diarrhea drugs is not quite as insane as it sounds, if you believe the government has a role restricting mind-altering substances.  Your gut and brain use a lot of the same neurotransmitters, so anything that affects your gut neurology and can get passed the blood-brain barrier will affect the brain as well.]

I would be surprised if the Georgia state legislature did this deliberately to hurt people with Irritable Bowel Syndrome.  My best guess is someone basically forgot that there are scheduled drugs besides opioids, and used the terms interchangeably in the bill.  Which actually concerns me much more, because it means the bill was written by someone who doesn’t understand medicine very well.