Vermont Governor Peter Shumlin has called the opioid addiction crisis a priority since he made it the sole focus of his state of the state address in 2014. Shumlin was at the University of Vermont Medical Center’s Day One treatment center today to announce more steps the state is taking to address the addiction crisis.
The governor was surrounded by physicians and treatment specialists as he outlined two fronts to battling the problem in Vermont. The first, Shumlin says, involves limiting the number of prescriptions. “If you’d go out and talk to addicts many of them will tell you ‘ I got into this mess because I was in a car accident and I got prescribed Oxycotin or I had some kind of physical ailment and I got prescribed Oxycotin. That got me started.’ So we are going to make three administrative recommendations that we think will help our prescribers be more careful as we hand out prescriptions for powerful painkillers.”
Vermont Health Commissioner Dr. Harry Chen outlined rule changes focused on primary care physicians. “ We expect Vermont providers when they are prescribing that they’ll assess an individual for risk for substance abuse. They’ll assess to make sure that they’re not getting medications elsewhere using the Vermont Prescription Monitoring System. They’ll make sure that they’re actually taking the medicine potentially with urine drug screens and pill counts. That patients will be actually informed and will consent to understanding that there are risks related to these drugs including addiction. And there’s a threshold in this rules which says if you get to a morphine equivalent dose that you actually have to do all those things all over again.”
The second area the state is addressing involves the backlog of people seeking treatment. The governor’s office notes that as of August, more than 2,800 people are in treatment in the state’s centers, up from about 1,700 in January 2014. But there is still a waiting list that Shumlin says is unacceptably high. “We still have over 400 folks who are ready for treatment, want to get treatment and can’t get access to treatment. We are treating now 65 percent more folks than we were when we started addressing this problem in 2014. One of the big challenges we face is having enough docs, folks, who are able to treat the people who want treatment.”
The treatment specialists and physicians surrounding the governor believe that the backlog could be eased if trained and licensed nurse practitioners and physicians assistants were allowed to prescribe treatment drugs. University of Vermont Department of Nursing Chair and Nurse Practitioner Rosemary Dale: “In Vermont there’s no legislative constraint to nurse practitioners prescribing any medically necessary drugs to any patient. Yet current federal legislation precludes nurse practitioners from treating patients for their opiate addiction.”
To help solve that and ease the backlog, Shumlin has joined with the New England governors in a letter to Congressional leaders asking for prompt passage of the Recovery Enhancement for Addiction Treatment Act. “It’s absolutely inconceivable that Congress wouldn’t pass this provision. I mean, why would you allow a health care provider to prescribe the drugs that get you addicted and not allow you to prescribe the drugs that would actually get you into recovery?”
The University of Vermont Medical Center also announced a new hotline that will allow primary care physicians to discuss difficult cases with chronic pain specialists.
