Overruling the FDA — in effect, nullifying federal health policy — is no small matter. The only other state to announce restrictions on the drug, Vermont, didn’t opt for an outright ban. Nonetheless, Patrick deserves the benefit of the doubt, given the extent of prescription drug abuse in the state, and the clear link between overuse of opioid painkillers and heroin addiction. As a temporary measure, the ban is warranted.
Still, there are patients in Massachusetts who would benefit from Zohydro, and they deserve a fair balancing of their needs versus the drug’s potential to exacerbate the addiction crisis. The FDA exists to assess those difficult trade-offs between safety and access, and it believes that Zohydro is not more harmful than other opioid painkillers, and may improve care for some patients. If the abuse-resistance measures the Patrick administration is demanding prove impractical — as they may — the state should not remain permanently out of sync with federal regulations.
Patrick’s announcement was the most controversial among a series of other moves he announced recently to address the spate of deaths caused by overdoses of prescription painkillers and heroin. The administration also allocated $20 million to treatment, sped up the implementation of a mandatory prescription-tracking system, and eased barriers that have prevented some first responders from carrying a drug that can save the life of people who’ve overdosed.
Those are all good steps. But the inescapable problem is that as long as opioid painkillers remain part of medicine, the goals of preventing addiction and managing pain will always push in opposite directions. In the long run, the best approach is to encourage the development of less dangerous, non-opioid painkillers to replace drugs like Oxycontin and Zohydro.
That’s not something the state can do by itself, but bans like Patrick’s are one of the few ways the government can nudge the drug industry into action. The FDA has tried to coax pharmaceutical companies into devoting more research resources to non-opioid painkillers, with limited success. The carrot approach may only go so far. If drug makers begin to fear state regulators, perhaps they’ll put more effort into developing alternatives. Abuse of prescription painkillers has contributed to a public health crisis in Massachusetts, creating a challenge the state’s robust pharmaceutical sector should embrace.