Washington State

Office of the Attorney General

Attorney General

Bob Ferguson


In the midst of nationwide opioid epidemic, HHS proposal weakening guidelines to reduce overprescribing, putting communities at risk

OLYMPIA — Attorney General Bob Ferguson and a bipartisan coalition of 38 other attorneys general today submitted a comment letter urging the federal government to reverse course on its proposal to eliminate opioid prescribing guidelines in the midst of the opioid epidemic.

The guidelines, issued by the Centers for Disease Control and Prevention (CDC) in 2016, curb overprescribing by providing health providers a framework for prescribing opioids. Overprescribing contributes to the opioid epidemic by increasing the illegal supply of opioids. U.S. Department of Health and Human Services (HHS) proposed eliminating key components of the guidelines in a draft report issued December 2018, specifically provisions relating to dose and duration of opioid treatment.

AG Ferguson and Montana Attorney General Tim Fox co-wrote the letter to Health and Human Services. The broad bipartisan support from state attorneys general across the nation highlights the dangerousness of the federal government’s proposal.

In addition to eliminating prescribing guidelines, the draft report pushes the same discredited claims that opioid manufacturers made for years prior to the epidemic, including the baseless assertion that opioids only have addictive properties in certain at-risk populations.

In fact, many studies demonstrate that anyone who takes an opioid is at risk for misuse and addiction, especially if they are exposed to longer duration prescriptions. For example, a study of a million surgical patients who had not previously taken opioids found that each additional week of opioid treatment increased the risk for opioid misuse by 20 percent. A refill increased their risk by 44 percent.

“In the midst of an epidemic that kills tens of thousands of Americans every year, it is unconscionable to minimize the dangers of opioids and return to the days of unrestrained prescribing,” Ferguson said.  “Going backwards now is unacceptable – and makes no sense. I’m grateful that so many of my colleagues are willing to join me in calling on the federal government to heed the overwhelming evidence and reverse its misguided proposal.”

In response to a growing opioid epidemic, the CDC issued guidelines in 2016 to give health care providers a framework to avoid overprescribing opioids. These guidelines do not apply to patients receiving active cancer treatment and end-of-life care. Evidence-based recommendations help providers make sound decisions about when to initiate opioid treatment and how much to prescribe to minimize risk to patients. The absence of such guidelines, along with the claim that addiction is rare, contributed to the opioid epidemic.

Leading medical experts in Washington also disagree with the report’s critiques of the CDC Guideline. The Washington Agency Medical Directors’ Group states, “the opioid epidemic began and was perpetuated with the idea that most prescribers can use risk assessment and decide for themselves what patients may need regarding opioids…Repeating the assumptions and mistakes from the past will not resolve this crisis.”

“As a matter of public safety,” the attorneys general write, “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.”

Washington and Montana are joined by Alaska, Colorado, Connecticut, Delaware, the District of Columbia, Florida, Guam, Idaho, Illinois, Iowa, Kentucky, Maine, Maryland, Massachusetts, Minnesota, Mississippi, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, South Dakota, Utah, Vermont, Virginia, West Virginia and Wyoming.


The Office of the Attorney General is the chief legal office for the state of Washington with attorneys and staff in 27 divisions across the state providing legal services to roughly 200 state agencies, boards and commissions. Visit www.atg.wa.gov to learn more.


Brionna Aho, Communications Director, (360) 753-2727; Brionna.aho@atg.wa.gov