Vermont Seeks New Rules for Opioid Prescribing

Vermont is aiming to lower incidence of opioid addiction by putting new restrictions on prescribers. For starters, the state health department has recommended limiting the number of opioid pills a doctor can prescribe; Gov. Peter Shumlin suggested 10 would be appropriate for patients undergoing minor procedures like those that might be performed in the urgent care setting, but the proposal currently on the table frames the amount as a “5-day supply for acute pain.” That may ultimately be customized according to what drug is prescribed, however. While the details are yet to be finalized, the core objective is to establish guidelines for all providers to follow, making it more difficult for addicts to “doctor shop” and also helping to prevent nonaddicts from having more drugs on hand than they actually need. Another requirement: providers will have to discuss potential negative effects of opiates—including the risk of addiction—with patients they write for. The proposed rules would also require providers to prescribe naloxone, a medication that can reverse the effects of an opioid overdose, when prescribing an opioid to patients who also use benzodiazepines. Finally, the rules would direct providers to consider alternative medical treatments and nonopioid drugs for minor injuries. (For more about current developments in treating pain, visit the JUCM Acute Pain Resource Center.)