After a survey of controlled substance prescribers in Maine reported a high incidence of opioid abuse by state residents, a legislative committee voted to move ahead with efforts designed to curb this abuse.

The survey was created by a work group formed by a legislative initiative titled "Resolve: To Reduce Opioid Overprescription, Overuse and Abuse." (Find this document at http://www.mainelegislature.org/legis/bills/bills_125th/billtexts/HP110202.asp.) Bonnie Lundquist, NP, an appointed member of the work group, said that although the survey was available to all prescribers, the majority of respondents to the survey were physicians and NPs. Lundquist said the most striking results of the survey include the following:

• 90% of prescribers characterize the opioid abuse and addiction problem in their area as moderate or severe
• 80% attempt to identify patients at risk for opioid diversion or addiction
• 85% try to reduce risk of addiction or diversion by using patient education or treatment agreements.

The survey also found that most prescribers use precautionary measures to avoid abuse, such as urine tests and pill counts. More than 350 respondents wrote comments, many of which indicated frustration with lack of treatment options, the state's prescription monitoring program, patients and legislation.

"The comments were very telling about how huge this problem is and how providers agonize over it," Lundquist said. Although the response rate was 10% of the state's controlled substance prescribers, the survey was not statistically valid because respondents were not chosen at random, she explained.

"Nevertheless, we do believe the survey is very informative," she said. "As a long-term pain management provider, I feel very strongly both about this topic and about the need for NPs to be at the table when such possible legislative action is considered."

In January, the Maine Legislature's Health and Human Services Committee reviewed the report from the work group (http://www.maine.gov/dhhs/osa/pubs/osa/2011/LD1501SASCFinalReport.pdf) and approved the establishment of a Drug Disposal Task Force to explore ways to dispose of expired and unused medications. The committee voted to continue to review the remaining recommendations. Lundquist is hopeful that the recommendations will be implemented quickly.

"I personally plan to continue following the progress of our report as it goes through state government," she said, "and I am optimistic that I will be appointed to the standing task force being established by the governor to deal with this issue."