New Hampshire medical board rejects governor’s strict opioid Rx proposal

Earlier this month, the New Hampshire Board of Medicine rejected a set of rules proposed by Gov. Maggie Hassan designed to more closely regulate doctors who prescribe opioid painkillers.

Gov. Hassan had proposed specifications for patient evaluations, physician education and testing, patient drug tests, alternative therapies, and mandatory use of New Hampshire’s prescription drug monitoring program.

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Instead, state regulators approved new rules that include requiring physicians and physician assistants to follow existing opioid-prescribing guidelines from state medical boards; perform appropriate risk assessment for patients who suffer from chronic pain; and to explain addiction, overdose, and dependency and criminal victimization to patients.

The new rules also include creating pain-management agreements with patients, conducting drug tests when appropriate, and providing patients with information on how to properly dispose of drugs.

“We’re doing something, but not necessarily everything our governor wants,” Dr. Louis Rosenthal, a Concord physician who is on the board, told the New Hampshire Union Leader. “You can’t hold (physician) licensees responsible for people who overdose from illicit substances.”

Gov. Hassan called the board’s action progress. “The Board of Medicine’s action, along with the Executive Council’s approval of my call today for a special legislative session on substance abuse, is important progress in our continued efforts to strengthen the state’s response to the heroin and opioid epidemic,” she said in a statement.

The governor’s proposal had drawn the ire of some doctors, hospitals, and patients. Throughout the country, patients have complained that efforts to crack down on unscrupulous doctors, pharmacies, and criminals seeking to divert painkillers have made it difficult for legitimate patients to get needed medications.

Additionally, many doctors have been slow to use the drug databases established by various states to curb drug abuse. "[The governor’s proposal] was a good first draft,” Dr. Travis Harker, a former president of the New Hampshire Medical Society, told the newspaper. “It brought a lot if ideas to the table but it wasn't mature enough to work in actual practice."