Governors will create plan to curb opioid use

From left, Senator Kelly Ayotte and Senator Jeanne Shaheen, both of New Hampshire, and Senator Rob Portman of Ohio, listen as Governor Peter Shumlin of Vermont, right, testified last month during a Senate Judiciary Committee hearing in Washington on attacking America’s epidemic of heroin and prescription drug abuse.

WASHINGTON — Alarmed at an epidemic of drug overdose deaths, the National Governors Association decided over the weekend to devise treatment protocols to reduce the use of opioid painkillers.

The guidelines are likely to include numerical limits on prescriptions, or other restrictions, governors said.

Bipartisan concern about the abuse of addictive pain medications unexpectedly dominated sessions of the National Governors Association, and governors said they would take their concerns to the White House, where they are scheduled to hold a business meeting with President Barack Obama on Monday after a more social gathering at the White House on Sunday night.

Gov. Peter Shumlin of Vermont, a Democrat, and Gov. Matt Bevin of Kentucky, a Republican, led the effort to press states to take action.

Opioids “are passed out like candy in America,’’ Shumlin said. He cited federal data showing that health care providers wrote more than 250 million prescriptions a year for painkillers, enough for every American adult to have a bottle of pills.

In 2014, more than 47,000 drug overdose deaths occurred in the United States, according to the Centers for Disease Control and Prevention, and opioids — primarily prescription pain medicines and heroin — were the main drugs responsible for overdose deaths.


The governors’ health and human services committee approved Shumlin’s proposal to develop protocols to ensure safer prescribing of opioid pain relievers.

Bevin said that the roots of the problem were economic, and that the solution must involve “the people who develop, sell, profit from and approve these drugs.’’

Governors said they had decided to act because they had not received enough help from doctors or from drug companies that make the addictive prescription pain medications.

Gov. Maggie Hassan of New Hampshire, a Democrat, said doctors had “pushed back’’ when she tried to limit the amount of opioids that could be prescribed by certain health care providers.

Governors heard a presentation by Andrew Dreyfus, the president of Blue Cross Blue Shield of Massachusetts, whose policies were described as a possible model for states. The company requires “prior authorization’’ for certain opioid prescriptions and requires some patients to use a single drugstore for opioid prescriptions.

With these and other safety measures, Dreyfus said, the Blue Cross Blue Shield plan has reduced claims for short-acting opioid painkillers like Vicodin and Percocet by 25 percent and reduced claims for long-acting opioids like OxyContin by 50 percent, by switching patients to short-acting pain treatments.

In Massachusetts, Gov. Charlie Baker, a Republican, and the legislature are working on a comprehensive bill to limit the amount of opioids that could be dispensed to patients on their first prescription. State officials said at least 1,100 people in Massachusetts died of opioid overdoses in 2014, an increase of 65 percent from 2012.

Dr. Patrice A. Harris, the chairwoman-elect of the American Medical Association, said doctors welcomed the opportunity to work with governors on solutions to end this public health problem. But she added, “The AMA wants to make sure that prescribing decisions — the decision to prescribe or not to prescribe — stay in the hands of physicians.’’


Most states have programs that collect and analyze data on the prescribing of controlled substances, and governors said doctors should routinely check these databases to identify patients who are abusing prescription drugs.

Governors said they expected drug companies to resist their efforts. But Shumlin said he was optimistic because “you have the most conservative Republican governors and the most liberal Democratic governors agreeing’’ on the urgent need for action to combat the epidemic.

A monograph prepared by the National Governors Association acknowledges the difficulties that its members face.

“Reducing the opioid pill supply, for example, can have the unintended consequence of increasing heroin use,’’ it said. “Laws aimed at unscrupulous providers can make ethical providers less willing to prescribe out of fear of scrutiny from law enforcement.’’ And “one state’s successful efforts to reduce illicit sources of prescription drugs can shift illegal activities to neighboring states.’’

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