A.G. Schneiderman Calls On The Federal Government To Adopt Proposed Guidelines For Prescribing Opioids For Chronic Pain

Guidelines From The Centers For Disease Control Can Assist Primary Care Physicians To Prescribe Opioids Properly

Schneiderman: By Adopting The Proposed Guidelines, We Can Reduce Prescription Drug Abuse By Providing Our Doctors With Better Guidance For Prescribing Opioids

NEW YORK – Attorney General Eric T. Schneiderman today called on the Centers for Disease Control and Prevention (CDC) to adopt its proposed guideline for prescribing opiates for chronic pain. The Attorney General sent a letter to the CDC highlighting the need for physicians to have more guidance on proper opioid prescribing practices.

“Too many lives have already been lost or destroyed by prescription drug abuse,” Attorney General Schneiderman said. “New York has taken important steps to fight this epidemic, but we must do more to end systematic problems in our healthcare system that are fueling a rise in opioid abuse. By adopting the proposed guidelines, we can reduce prescription drug abuse by providing doctors with better guidance to help them prescribe opioids in a safer and more effective manner.”

Opioid overdose rates are at a historic high. As data released last month by the CDC shows, 18,893 people died from opioid pain reliever overdoses in 2014, a 16% increase from 2013. In New York, from 2003 to 2012, deaths involving opioid analgesics increased four-fold, from 186 deaths in 2003 to 914 deaths in 2012. A contributing factor to the opioid overdose epidemic is the fact that physicians are writing more prescriptions for opioid pain relievers than ever before. As a result, the use of prescription opioids in the United States has increased ten-fold over the past 25 years.  The CDC reports that there is a lack of evidence of effectiveness of long-term opioid therapy, while clear evidence that opioid pain medication use presents serious risks, including addiction. Consequently, physicians can benefit from guidance on how to properly prescribe opioid pain medication – as set forth by the CDC’s proposed guideline.

In particular, CDC’s proposed guidelines encourages health care providers to review their patients’ history of controlled substance prescriptions using state prescription drug monitoring program data to determine whether the patient is receiving opioid dosages that put him or her at high risk for overdose, something already required in New York. Other key components of the proposed guidelines include preference for nondrug and nonopioid drug therapy for chronic pain, and that providers should only add opioid therapy if expected benefits for both pain and function are anticipated to outweigh risks to the patient. Furthermore, providers should also periodically assess the risk from opioid-related harms, such as the risk of abuse and overdose.

New York’s historic Internet System for Tracking Over Prescribing (“I-STOP”) legislation was signed into law on August 27, 2012, an initiative that was spearheaded by the Attorney General’s office (OAG). This law made New York the first state in the nation to ensure every prescription for a controlled substance is tracked in a real-time database accessed by both prescribers and pharmacists. New York’s I-STOP program, which became mandatory in 2013, has helped reduce prescription drug abuse, decreasing doctor shopping by almost 75%.  In addition to I-STOP, OAG has taken other actions to combat New York’s prescription drug abuse epidemic including  prosecution of many health care providers who illegally prescribed and diverted opioids; enforcement of laws that require parity in health plan coverage of mental health and addiction treatment; and creation of the OAG Community Overdose Prevention (COP) Program, which equips New York law enforcement agencies with a life-saving heroin overdose antidote, has saved more than 100 lives.

Attorney General Schneiderman also joined a joint letter to the CDC by state Attorneys General urging CDC to adopt the guidelines.

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