Maine Attorney General Janet Mills and the attorneys general of 36 other states and U.S. territories expressed support Monday for offering doctors financial incentives to seek pain therapies that don’t involve the prescription of opioid painkillers.

In a letter to Marilyn Tavenner, president and CEO of America’s Health Insurance Plans – a political advocacy and trade association that sells health insurance coverage to millions of Americans – the attorneys general urged AHIP to prioritize other treatment options over opioid prescriptions for the treatment of chronic, non-cancer pain.

Mills and her peers said the health care industry needs to promote the use of alternatives such as physical therapy, acupuncture, massage and chiropractic care to treat patients’ chronic pain.

The attorneys general said the unnecessary prescription of opioid painkillers by physicians has contributed to the opioid epidemic in Maine and across the nation.

“Reducing the frequency with which opioids are prescribed will not leave patients without effective pain management options,” their letter states. “When patients seek treatment for any of the myriad conditions that cause chronic pain, doctors should be encouraged to explore and prescribe effective non-opioid alternatives,” including “physical therapy, acupuncture, massage and chiropractic care.”

“Last year, Maine enacted a law limiting opioid prescriptions and that law is beginning to have a positive impact,” Mills said in a statement.

Mills said health insurers need to reduce any financial incentives to prescribing addictive narcotics and begin to offer greater coverage for alternative therapies.

Maine had the highest rate in the nation of prescriptions issued for long-term, extended-release opioids, according to a 2014 report by the U.S. Centers for Disease Control and Prevention. Since then, the numbers have decreased, but Maine is still seeing an average of almost one drug overdose death each day, according to Mills.

The attorneys general said millions of Americans are at risk of developing a dependency on opioids unless steps are taken to reduce the number of opioid prescriptions.

“The opioid epidemic is the pre-eminent public health crisis of our time. Statistics from the Surgeon General of the United States indicate that as many as 2 million Americans are currently addicted to or otherwise dependent upon prescription opioids,” the attorneys general said in their letter. “The human cost is even more staggering. Opioid overdoses kill 91 Americans every single day. More than half of those deaths involve prescription opioids.”