Rhode Island Follow Charlie

Overdose epidemic: R.I. looking to Massachusetts for prescription limit curbs

PROVIDENCE, R.I. — State health officials are working with Governor Raimondo’s office to develop prescribing limits to curb dependency on prescription painkillers in Rhode Island similar to the measure Massachusetts’ governor signed into law Monday.

The new Massachusetts law limits initial prescriptions for painkillers such as Vicodin, Oxycontin and Percocet after surgery or an injury to a seven-day supply. Officials in Vermont and Maine say they are considering similar actions.

Rhode Island currently has no mandated prescribing limits on painkillers.

“The Department of Health and the Governor’s office are paying close attention to what Massachusetts is doing,’’ Joseph Wendelken, a health department spokesman, said in an email, “and we’re evaluating different proposals of our own for limiting the duration of prescriptions in certain instances.”

He declined to provide details, saying nothing has been finalized. He said it was unclear whether a proposal would be introduced this legislative session.

Sen. Joshua Miller, who chairs the Senate Committee on Health and Human Services, has introduced a package of bills aimed at improving insurance coverage and treatment for opioid addiction — but so far nothing that would address prescribing practices.

“I think we should be considering it because prescribing opiates is such a big contributor to the crisis,’’ Miller, D-Cranston, said Monday. “Longer prescriptions, like 30-day prescriptions, leave a lot of drugs (unused) that could end up in the hands of relatives or other people. “

Rhode Island's health director or health insurance commissioner could propose language, Miller said, to modify bills pending in the General Assembly this session to include prescribing limits.

But any proposal to limit prescribing in Rhode Island will no doubt face stiff opposition.

Former Health Director Michael D. Fine said that when his department attempted to enact regulations to limit prescribing about three years ago, it faced “a huge amount of pushback” from professional groups representing physicians, dentists and nurses. “It was a pitched battle,” he said.

Fine’s department enacted regulations with guidelines for using opioids to treat chronic pain patients, such as signing doctor-patient treatment agreements. But there were no prescribing limits.

“We didn’t think it was appropriate in Rhode Island,’’ Steven R. DeToy, the Rhode Island Medical Society’s director of government and public affairs, said. “Ninety-nine percent of the people who get opioids are legitimate prescriptions.’’

By limiting prescribing, DeToy said, “all you do is cut down on one source of supply and people go to another source of supply’’ such as heroin. He likened the approach to squeezing a balloon: one side gets smaller and the other bigger. The way to reduce demand, he said, is not to limit supply but to treat addiction.