Cutting Off the Supply: The Good and Bad of Opioid Prescription Limits

In October 2016, Vermont Governor Peter Shumlin proposed regulations that would limit the number of opioid-based prescriptions a patient can receive based on certain criteria. At face value this seems like a simple, no-nonsense way to curb the state’s raging opioid epidemic, but some addiction treatment professionals aren’t so sure it will work. Here are the benefits and the shortcomings of state-based opioid prescription limits.

As many people’s first exposure to the endorphin rush of opioids is through a prescription, giving out fewer prescriptions can be a helpful addiction prevention tool. Currently, opioids are prescribed so readily that every household in the United States could have its own bottle. Under a prescription limit, opioid-based medicines like Vicodin will become less common. Fewer pills in the market means fewer chances for abuse, right? That’s the logic being used in Vermont.

Unfortunately, state-based opioid prescription limits are limited to states that have them. Patients abusing opioids will be able to drive across state borders and see a different physician with more lenient prescribing privileges. Also, more restrictive prescribing guidelines could prevent people from becoming addicted to opioids in the first place, but they won’t make a dent in the number of people currently abusing opioids or help them to get treatment.

However, helping doctors understand the serious risks inherent in overprescribing opioid-based medications is a step in the right direction. The public looks to the medical profession to manage and ultimately eliminate opioid addiction, but doctors too often find themselves empty-handed when it comes to helping a patient overcome their prescription opioid addiction. Doctors receive little to no training in addiction identification or treatment. That has to change.

It’s important that those patients currently taking an opioid-based prescription as their doctor recommends will be allowed to continue using their medication under the new guidelines. A small but vocal contingent of patients reliant on opioid-based medications, where nothing else has worked, argue that the prescription opioid epidemic has made it difficult for them to get the medical care they need. There are pain conditions that are difficult to treat and some patients find opioid-medication to be their best treatment option. This need for opioids by some patients cannot be overlooked.

With so many people dying from opioid-related drug overdose, tens of thousands of lives lost each year, communities are desperate for an immediate solution to this public health crisis. There are definite advantages to limiting a state’s number of opioid-based prescriptions, but there are also serious drawbacks that must be considered in order to save as many lives as possible. No single regulation will solve every problem presented in the opioid epidemic. We can limit the supply of prescription opioids to the public, but as long as there’s a demand for opioid-based drugs, addiction will continue to be a major public health issue.

Learn from the past. When we’ve cut off opioid pills, users are forced to switch to heroin. We have to dig deeper into this issue by providing better training to doctors about prescribing opioids and identifying addiction, and quality treatment to those with a substance abuse problem. The solution to the opioid epidemic is multifaceted and lies in prevention, physician training, and access to quality treatment.