WASHINGTON — President Barack Obama on Monday declined to endorse the boldest proposal from the nation's governors to tackle the heroin crisis: limiting the number of high-powered painkillers doctors can prescribe at a time.
A recommendation to limit the number of Oxycontin pills that doctors can hand out gained bipartisan support at the National Governors Association's winter meeting over the weekend.
But Obama was cool to the idea at a meeting with the governors he hosted at the White House on Monday, noting that painkillers are sometimes the only realistic treatment option for people in rural communities.
"If we go to doctors right now and say 'Don't overprescribe' without providing some mechanisms for people in these communities to deal with the pain that they have or the issues that they have, then we're not going to solve the problem, because the pain is real, the mental illness is real," Obama said. "In some cases, addiction is already there."
Addiction to heroin and opiate painkillers is killing 78 Americans a day, according to the Centers for Disease Control and Prevention, with addicts often turning from prescription Oxycontin to heroin, which is cheaper and can be easier to obtain.
Although the governors did not commit to a specific number of pills that patients should be given, Vermont Gov. Peter Shumlin, who pushed for the proposal, said that for nonchronic conditions, it should be no more than 10, noting that 250 million doses of Oxycontin were prescribed in 2012.
"You can't convince me that we've got 250 million Americans in chronic pain," he said.
Among the governors who agreed to Shumlin's proposal was conservative Republican Gov. Matt Bevin of Kentucky, which the liberal Democrat said spoke to the urgency of the crisis because the two are so far apart politically. Obama also applauded the bipartisan commitment to addressing the crisis.
"This is an area where I can get agreement from Bernie Sanders and Mitch McConnell. That doesn't happen that often," Obama said.
Among the governors' other recommendations were for Congress to authorize emergency funding to states to address the addiction epidemic and to allow nurse practitioners and physician assistance to prescribe buprenorphine, a synthetic opioid that's used to treat addiction.
Obama said any attempt to limit the number of pills that can be prescribed has to be part of a comprehensive approach. But he also expressed sympathy with rural Americans who cannot afford surgery or other costly, time-consuming treatment for painful injuries or illness.
Dr. Steven Stack, president of the American Medical Association, said Obama was right to question the potential consequences of restraints on doctors.
"The complexity of the problem makes it difficult to create a successful one-size-fits-all approach," Stack said in a statement on Monday.
The president also urged governors to talk to their congressional delegations about how the Pacific Rim trade deal could boost businesses in their states. The administration is facing grim prospects for moving its Trans Pacific Partnership through Congress in the near term.
The leaders of the governors association, Republican Gary Herbert of Utah and Democrat Terry McAuliffe of Virginia, said they supported the trade deal.
Obama also encouraged governors to prepare to test patients for the Zika virus, especially pregnant women, and to treat them if necessary. The White House is requesting $1.9 billion in emergency funding from Congress to combat the mosquito-borne virus.