Painkiller Prescription Limits

A Washington State law signed last year attempts to limit long-term use of opioid painkillers, but some argue that it is too stringent.

The increasing prescription of opioid painkillers over the last 15 years or so has brought many patients relief from long-term pain, but it has also raised concerns over widespread dependence on the drugs and potential risks, including fatal overdose. A number of organizations, including the Departments of Defense and Veterans Affairs and the CDC, have taken steps to reduce painkiller prescription levels, but the most aggressive action has been taken in Washington State. A law that went into effect there last year requires physicians to refer patients receiving opioids equivalent to more than 120 mg of morphine per day to a pain specialist if their condition does not improve.

According to a recent New York Times article, the new law has prompted physicians to help some patients transition to lower doses of painkillers. But it has left other patients with debilitating, painful conditions frustrated at their inability to refill their painkiller prescriptions and turned pain clinic doctors into the ultimate arbiters of whether these patients can continue to receive them. The American Pain Foundation, a patient advocacy group funded by drug makers, has called the law “inhumane,” and some of the law’s supporters worry that patients’ frustration with its requirements will lead to a backlash. In addition, how to deal with patients who have become dependent on painkillers remains a significant challenge.