Attorney General Mills urges adoption of new opioid prescribing guidelines

January 14, 2016

AUGUSTA ? As deaths from drug overdoses skyrocket in Maine and across the nation, Attorney General Janet T. Mills is urging the federal Centers for Disease Control and Prevention to adopt proposed opioid prescribing guidelines for physicians. In a letter to CDC Director Tom Frieden Attorney General Mills expressed concern that the potential harms associated with opioids must be better balanced with any benefits.

?The increase in overdose deaths has made prescribing protocols a law enforcement and public safety issue,? said Attorney General Mills. ?Unfortunately, many prescribers, particularly primary care and family physicians, lack clear and practical guidance in deciding when and how to prescribe opioids. Some are afraid to prescribe opioids at all for fear that they will jeopardize their patients health ? or even their medical licenses. Others provide their patients with opioids when alternative treatments might be a more effective long term method of care.?

In 2014, Maine experienced a record 208 deaths caused by drug overdose, and through the first nine months of 2015 there were 174 deaths from drug overdose. Of the deaths in the first nine months of 2015, 113 (65%) involved at least one pharmaceutical drug and 111 (64%) involved at least one illicit drug. Many of these deaths (29%) were caused by a combination of pharmaceutical and illicit drugs. Pharmaceutical opioids remain a key substance category, with 70 deaths (40%) caused by at least one pharmaceutical opioid.

?The Department of Justice reports that eighty percent of people arrested for heroin offenses say they started using prescription painkillers,? said Attorney General Mills. ?We are awash in these substances. The CDC reports that in 2012 healthcare providers wrote 259 million prescriptions for painkillers. This is enough for every adult in the United States to have a bottle of pills. Last year in Maine there were about one million scripts for opioids written. As law enforcement works to interdict the supply of heroin and fentanyl, we need doctors and other prescribers to reduce the supply of prescription opioids.?

In December Attorney General Mills wrote to Maine prescribers to urge them to take steps to address Maine?s opioid crisis. Suggested steps included: begin incorporating the CDC?s proposed guidelines into their practices; become eligible to prescribe opioid replacement therapy, such as buprenorphine; check the state?s Prescription Drug Monitoring Program for every script of a controlled substance; and, warn patients about the potential dangers and consequences of misusing or diverting opioids.

The letter sent to the US CDC regarding prescribing protocols for opioids was signed by Attorney General Mills and 35 other attorneys general.

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The US CDC has proposed new opioid prescribing guidelines to curb the number and duration of scripts written and to encourage non-opioid treatment of pain

Supporting documents

PDF of AGs Letter to CDC re Opioid Prescribers 2016-01-13