Why Vermont Wants Limits On Prescription Opioids

FILE - This Feb. 19, 2013, file photo, shows OxyContin pills arranged for a photo at a pharmacy in Montpelier, Vt. Prescription painkillers should not be a first-choice for treating common ailments like back pain and arthritis, according to new federal guidelines designed to reshape how doctors prescribe drugs like OxyContin and Vicodin. Amid an epidemic of addiction and abuse tied to these powerful opioids drugs, the CDC is urging general doctors to try physical therapy, exercise and over-the-counter pain medications before turning to painkillers for chronic pain. (AP Photo/Toby Talbot, File)

Vermont Gov. Peter Shumlin has taken several steps over the past several years to combat his state’s opioid crisis, but he’s now taking perhaps his boldest move by announcing proposed limits on painkiller prescriptions.

During a recent conference held outside the Vermont Department of Health in Burlington, Shumlin said his plan calls for doctors and patients to work together to determine specific levels of pain and then have appropriate amounts of medication dispensed based on that. For minor procedures resulting in moderate pain, doctors could prescribe no more than nine to 12 opioid painkillers, based on the medication. Higher limits would be set for more complicated procedures or treating severe pain.

If approved by after a period of public comment and review by a state legislative committee, the new guidelines could be made official as early as the end of the month.

“This is not a hard problem to solve. We didn’t have a heroin crisis in America before OxyContin was approved and started being handed out like candy,” said Shumlin to the New York Times. “If politicians would lead a more rational conversation about how we manage pain in America, we could fix the majority of this problem with a click of our fingers.”

However, some health officials believe Shumlin’s proposal is a well-intentioned measure that could backfire. Liz Evans, the executive director of the New York Harm Reduction Educators, expressed concern that limited medication access would only push drug use further underground.

“I think prohibiting access to pain medication can result in pushing people to using more illicit drugs in a more dangerous way without being paired with existing evidence-based public health strategies that are known to work,” she said.

Shumlin told the New York Times he realized “we had a full-blown health crisis on our hands” as soon as he took office in 2011. His entire State of the State address in January 2014 vowed to tackle the problem head-on and put forth several initiatives in addressing the opioid crisis.

The governor immediately allocated $200,000 to allow treatment centers to increase their staff and reduce waiting lists, in addition to $760,000 for the following year to allow courts to assess offenders and determine who would benefit more greatly from treatment or prison. Shumlin also launched plans to help identify drug hot spots in the state, and held a statewide forum to discuss ideas on drug abuse treatment options, education and prevention.

Last June, Shumlin signed a bill into law that included chronic pain as a qualifying condition to receive medical marijuana, with the goal to reduce the number of patients managing their pain powerful opioids.