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The home for VPR's coverage of health and health industry issues affecting the state of Vermont.

New Report Applauds Vermont's Policies Guiding Pain Medication

ACSCAN-state-pain-policy.png
American Cancer Society Cancer Action Network
A new report that ranks states' policies that govern the way doctors prescribe pain medications gives Vermont an "A". "Higher grades mean more balanced state policies influencing pain management, including with the medical use of opioid analgesics."

Vermont gets an “A” for state policies that govern the way doctors prescribe pain medications. That’s according to new study conducted by the University of Wisconsin School of Medicine and Public Health, with support from the American Cancer Society.

The state-by-state report card looks primarily at legislation and rules that spell out for doctors how to make sure that people in pain get the medications they need to maintain some quality of life as they battle serious conditions, like cancer.

The study also looks at how states are trying to keep opioids out of the hands of people likely to abuse them. David Woodmansee, a spokesman for the American Cancer Society, says Vermont strikes the right balance, because it does not discourage or prevent doctors from writing appropriate prescriptions.

“You have a lack of impeding policies but you also have a nice array of positive policies that outline for most medical professionals exactly what the parameters for prescribing these drugs legitimately are,” Woodmansee said.

According to the report, “although a state can adopt numerous positive policies to ensure adequate pain relief for all patients, an “A” can be achieved only if there is no restrictive or ambiguous language in pain policy.” Vermont was one of 15 states that earned an “A.” The lowest grade was “C,” going to Illinois and Tennessee.

Since the study was conducted, The Vermont Board of Medical Practice has added an emergency rule pertaining to the prescription of a new form of hydrocodone, which is marketed as Zohydro. The drug comes in a form that some worry will be easy to abuse. Woodmansee, of the American Cancer Society, says the state is wise to update its policies when necessary to prevent addiction.

“That’s the way to make sure that we evolve to the point where we all want to be, where we can eliminate or at least minimize abuse or diversion and still make sure that cancer patients and those that really need these drugs have access to them,” he said.

One of the agencies charged with making sure that doctors prescribe pain relief responsibly is the Board of Medical Practice. Executive Director David Herlihy says of the roughly 300 complaints against providers made in a typical year, about half relate to a doctor’s decision whether or not to prescribe opioids for pain. Some patients complain they are not getting the drugs they need. But some doctors are getting more cautious as they access data reported by pharmacies about all the prescriptions each patient is filling. Vermont’s Health Commissioner can also look at prescription data for each doctor to monitor their practices.

“The Board is dedicated to doing everything we can to help provide [them] with the knowledge they need to engage in a good level of practice. We updated the policy this year and three times we’ve partnered with Boston University Medical School, which is a recognized leader in this field, to do training on opioid prescribing.”

Herlihy says additional rules are yet to be written strengthening guidelines for opioid prescribers as required in a new law enacted this year.

This post was updated at 4:32 p.m. on July 16, 2014 to include comments from David Herlihy.