Obama rejects governors' proposal to limit painkiller Rxs

President Obama this week rejected a proposal from the nation’s governors that sought to fight the heroin epidemic by limiting the number of painkillers doctors could prescribe.

During a meeting at the White House, Obama said arbitrarily limiting painkiller prescriptions might hurt people in rural communities, as sometimes painkillers are the only treatment option available.

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"If we go to doctors right now and say 'Don't overprescribe' without providing some mechanisms for people in these communities to deal with the pain that they have or the issues that they have, then we're not going to solve the problem, because the pain is real, the mental illness is real," President Obama said. "In some cases, addiction is already there."

President Obama said he favors a comprehensive approach that goes past prescribing.

Many addiction experts believe the overprescribing of powerful opioid painkillers has fueled the recent heroin epidemic, as people turn to the cheaper street drug once their access to painkillers ends. According to the Centers for Disease Control and Prevention, heroin and opioid painkillers kill 78 American every day.

Vermont Gov. Peter Shumlin said patients with non-chronic conditions should be prescribed no more than 10 painkillers. "You can't convince me that we've got 250 million Americans in chronic pain," Shumlin told the Associated Press.

Jeffrey Fudin, BS, PharmD, FCCP, FASHP, Diplomate, American Academy of Pain Management, called the governor’s proposal to limit the number of painkillers doctors could prescribe a knee-jerk reaction.

“There are many things that can be done to mitigate against opioid abuse risk, but limiting number of dosage units isn't one of them,” Fudin told Drug Topics. “More likely than not that would serve to inconvenience patients, elevate co-pays, cause a bottleneck in physician office visits and phone calls, and increase heroin use, the latter of which could increase other public health risks such as hepatitis C, HIV, and endocarditis.”

In a blog, Governors and politicians must think outside of the [pill] box, Fudin urged increased access to trained pharmacy pain clinicians and authorization for payment for such services.