More than three dozen state attorneys general, including Vermont’s, have sent a letter to the US Department of Health and Human Services objecting to a draft report on best practices for pain physicians.
The chief complaint, accordiong to the letter, is an apparent deviation from opioid-prescribing guidelines issued by the federal Centers for Disease Control in 2016. The CDC report recommends that three days of opioids are enough for most patients with acute pain, and that seven days or more “will rarely be needed.”
Citing criticism from some doctors and patients, DHHS is recommending “a more even-handed approach” that it says would preserve access to opioid pain relievers for pepople who need them.
The agency says “an unintended consequence” of the CDC guidelines is that many doctors have cut back on opioid prescriptions or stopped prescribing them all together. That’s led some patients “to consider obtaining opioids from illicit sources or suicide.”
The AG’s letter argues that the CDC recommendations were prepared based on the best available evidence of opioids benefits and risks and should be part of the proposed new guidelines.
“The Draft Report should be revised to clearly state that there is no completely safe opioid dose, and that higher doses are particularly – and predictably – risky”
Donovan described the statistics on opioid prescribing in Vermont as “staggering.” In 2015, health care providers in the state wrote 62.5 opioid prescriptions for every 100 residents. And, he said, the rate of Neonatal Abstinence syndrome increased 48-fold in the last two decades.
“The report suggests providers can rely solely on their judgement instead of consulting evidence-based recommendations,” he said. “By doing so, it weakens recommendations for opioid prescription duration and dosage.”
DHHS said the recommendations will be finalized and submitted to Congress in 2019, following a 90-day public comment period.