Pubdate: Thu, 25 Feb 2016
Source: New York Times (NY)
Copyright: 2016 The New York Times Company


State governments are at the front lines of the country's epidemic of 
drug overdose deaths. That's why it is important that the National 
Governors Association says it will come up with protocols for 
dispensing prescription painkillers that are among the biggest 
sources of addiction and abuse in the country.

The protocols, or guidelines, would restrict how and under what 
circumstances doctors could prescribe a category of pain drugs known 
as opioids. They might, for example, impose limits on how many pills 
doctors could prescribe to patients who have had minor surgery or 
dental procedures.

More than 47,000 people died from drug overdoses in 2014; 61 percent 
of those deaths involved opioids like the prescription drug 
oxycodone, and illegal substances like heroin, according to the 
Centers for Disease Control and Prevention. The rate of drug overdose 
deaths has increased by 140 percent since 2000, while prescriptions 
for opioid painkillers have quadrupled in roughly the same period. 
Experts say many patients who become addicted go on to use heroin and 
other illegal opioids.

The governors association's health and human services committee is 
expected to present the protocols at a meeting in July. Legislators 
and governors in each state could then adopt those standards into 
their laws and regulations, which would make meaningful enforcement 
against excessive prescriptions more likely. Some leaders intend to 
act even sooner. The governors of New England states like Vermont and 
Massachusetts say they will work together to come up with common 
prescribing guidelines for their states within a few weeks.

Done right, the guidelines - being developed with medical 
specialists, government regulators, insurance companies and other 
experts - should reduce the number of excessive prescriptions. 
Similar efforts by some states and insurance companies have shown 
promising results. Florida, for example, reduced its prescription 
drug overdose death rate by 23 percent between 2010 and 2012 after it 
strengthened its prescribing laws and increased enforcement against 
doctors who dispensed too many pills, often because it was 
financially lucrative. And Blue Cross Blue Shield of Massachusetts 
has reduced opioid use by, among other things, requiring some 
patients to use just one pharmacy to fill their prescriptions.

On the federal front, the C.D.C. is expected to publish voluntary 
guidelines soon for doctors in treating chronic pain in adults. And 
Congress is considering a bill that would require the secretary of 
health and human services to convene a task force to develop best 
practices for prescribing painkillers.

Drug companies and some doctors will push back against any limits on 
prescriptions enacted by state lawmakers. The American Medical 
Association says the decision to prescribe drugs should "stay in the 
hands of physicians." Of course, doctors should have discretion to 
make medical decisions, including what drugs to use, but state 
governments also have a duty to protect people by placing sensible 
limits on the use of risky substances.

Obviously, reducing the number of opioid prescriptions only addresses 
part of the addiction problem. Earlier this month, President Obama 
proposed spending $1.1 billion on treatment and prevention programs. 
And Senator Jeanne Shaheen, Democrat of New Hampshire, has proposed 
$600 million in emergency funding to address the opioid crisis. These 
requests are surely reasonable, given the size of the national problem.
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