As the prescription opioid and heroin epidemic spreads like wildfire across the nation, states are pursuing a slew of legislative measures designed to reduce the amount of painkillers doctors can prescribe for patients.
According to a report by the New York Times, statehouses across the country are contemplating roughly 375 different proposals that would "regulate pain clinics and several aspects of prescribing painkillers."
The Times reports that Massachusetts is poised to pass a bill into law that would limit doctors' prescribing painkillers after an injury or a surgery to only seven days' worth of pills. Vermont and Maine could be on a similar track.
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In light of the national surge in the abuse of opioid painkillers like Percocet and Vicodin — which often serve as gateway drugs to heroin — state lawmakers have grown increasingly inclined to intervene in how the medical community goes about prescribing them.
At a meeting of the National Governors Association in February, discussion of how states could take action — both alone and in-concert — to stem the flow of prescription painkillers was a major focus. Noting that nearly 30,000 people die every year from prescription opioid and heroin misuse and abuse, a joint statement put out by the NGA and the American Medical Association during that meeting called attention to substance abuse to be understood as "a medical disease that needs our care and compassion." Governors at the meeting were strikingly passionate about curbing painkiller prescriptions, which Vermont Gov. Peter Shumlin described as being "passed out like candy in America."
Health care providers wrote roughly 260 million prescriptions for painkiller in 2012, according to the Centers for Disease Control and Prevention — close to enough for every adult in America to have a bottle, and double the rate of prescription in Canada.
States have grown keen on taking changes in drug policy into their own hands in light of the federal government's sluggish response to the epidemic. But there are signs that things that help could be on the way from Washington. Last week the Senate passed a bill 94 to 1 which, according to the Washington Post, would:
Establish grant programs to help state and local governments improve education and treatment for drug abuse, encourage medical providers to reduce unnecessary prescriptions, commit resources to help veterans deal with addiction, and give local law enforcement and mental health officials tools to lower the death rate from overdoses.
The bill has yet to go before the House of Representatives, and it still needs to have funds appropriated for it, but given how easily it passed in the Senate, its advocates have strong grounds for optimism.
At the moment, a bipartisan consensus is emerging on how to stop the growing rates of addiction. But the political durability of reforms that would strictly limit prescription rates is an open question — the new state measures are likely to eventually spur a debate about how much the government should be able to intervene in medical practice.
In a country where wide swaths of the population are still skeptical of President Barack Obama's Affordable Care Act — a law that has allowed the federal government to play a role in coordinating insurance but fully preserves private medical practice and private health insurance — it seems only logical that at least conservatives and medical professionals would resist the idea of legislatures prescribing how doctors go about handling pain management.
But right now, that issue seems distant. The epidemic is so dire, and the demographics that are being hit by it worst are so central to the Republican base, that for the moment, debates on government overreach are on the back burner.