Office of the Vermont Attorney General

Attorney General Donovan Objects to Draft Report by Pain Management Task Force

April 1, 2019

Contact: Josh Diamond, Deputy Attorney General, 802-828-3171

Attorney General T.J. Donovan has joined 38 state attorneys general to send a letter to the U.S. Department of Health and Human Services (HHS) criticizing the Pain Management Best Practices Inter-Agency Task Force Draft Report. The letter was addressed to Dr. Vanila Singh, chief medical officer for the Office of the Assistant Secretary for Health.

As it stands, the Draft Report deviates from guidelines published by the Centers for Disease Control and Prevention (CDC), which are aimed at decreasing the risk of opioid misuse. The report suggests providers can rely solely on their judgement instead of consulting evidence-based recommendations. By doing so, it weakens recommendations for opioid prescription duration and dosage.

“As attorneys general, we have witnessed the devastating effect of unfettered opioid manufacturing, distribution and prescribing on our public health, social services and criminal justice systems. The well-established risks associated with higher doses of opioids, prescriptions of longer duration, and concurrent prescriptions of opioids and benzodiazepines demand continued constraints,” reads the NAAG letter signed by 39 state and territory attorneys general.

The letter includes several other concerns, including that HHS does not provide a reason for departing from evidence-based CDC guidelines and does not explicitly state that there is no completely safe opioid dosage.

“Moving away from the CDC Guideline at this critical time would undermine ongoing legislative initiatives, as well as refinements to standards of medical care,” the letter continued. “As a matter of public safety, there is simply no justification to move away from the CDC Guideline to encourage more liberal use of an ineffective treatment that causes nearly 50,000 deaths annually.”

Vermont’s statistics are staggering. For example, in 2015, Vermont healthcare providers wrote 62.5 opioid prescriptions for every 100 Vermonters. In Vermont, the rate of incidents of Neonatal Abstinence Syndrome increased almost 48-fold in less than 20 years.

Last modified: April 1, 2019