What’s Massachusetts thinking?

The newest twist in the painkiller abuse debate is that Massachusetts Governor Charlie Baker has  proposed legislation that has me in dejected disbelief. The bill would restrict both doctors and dentists from prescribing more than 72 hours of medication to patients upon initial injury or surgery.  I understand the thought but it is wrongheaded.

In proposing the legislation, the Governor is reacting to the more than 1,000 painkiller overdose deaths in the state in 2014 and something clearly needs to be done.  I get it.  But the legislation is an over-reaction and will likely cause unnecessary pain and suffering. Sadly the legislation accelerates the trend of politicians and regulators practicing medicine.

While Governor Baker’s proposed bill promises to reduce opioid related overdoses, it would also limit people suffering from legitimate pain access to the necessary treatments for their condition. We’ve seen the painkiller zero-sum game solution play out in other states, with intolerable outcomes, namely, cancer patients being denied treatments in Florida.

A concrete example of government overreach is when earlier this year, the DEA upscheduled hydrocodone to a Schedule II drug, making it more difficult for patients to receive their medication, for doctors to prescribe them and for pharmacists to fill the prescriptions.  In fact, a recent survey by the National Fibromyalgia & Chronic Pain Association revealed that approximately two-thirds of survey respondents reported finding it more difficult to access hydrocodone-combination prescriptions. More than 15% of the respondents reported negative impacts on the relationships with their doctors as a result of the upscheduling.

Legislation, however well intended, can have unintended public health consequences. People in pain who are compliant and use their medications responsibly are being punished in an effort to reduce the harm from inappropriate use of the same medications.    We should be able to solve the problem of drug abuse without making people in pain suffer more.

Legislation that would make a difference is one that expands insurance coverage for alternative treatments and access to free addiction treatment.  The long term solution requires Congress to get serious about investing in research that will discover safer and more effective drugs so opioids can be retired as the primary agent for relieving pain.

Fighting opioid abuse and chronic pain has no simple solution.  Politicians, like Governor Baker cannot ignore the needs of people in pain while addressing the drug crisis.  Restricting patient’s access to medication they desperately need is not the answer. The problem won’t end with broad regulation of medications. The solution requires a more comprehensive approach including public education.  The opioid crisis must first focus on the demand not the supply or we will just see a migration toward other drugs of abuse that could be even more harmful.