Patients with legitimate needs for pain medication are facing a growing number of obstacles. Patient groups and health providers are increasingly challenging the limits placed on prescription opioids in the name of combating the ongoing epidemic. Approximately 115 Americans die each day from opioid overdose, according to the CDC, prompting nearly 30 states to pass laws governing how long patients can get opioids or how strong a daily dose can be. Some require long-term users to submit to tablet counts or urine tests that often are not covered by insurance. In the private sector, liability worries have some pharmacies refusing to stock opioids altogether, while some insurers and PBMs have said they would limit the doses. More advocacy and doctors' groups say the measures, while often harming legitimate patients, do little to curtail an epidemic increasingly fueled by illicit rather than prescribed opioids. For example, some evidence suggests constraints on prescriptions are driving opioid misusers to illegal fentanyl, a drug whose use is more likely to result in death. Lawmakers and addiction specialists, however, say that the limits are needed because opioids are extremely addictive, and that overprescribing helped fuel the current crisis. Studies have shown there are often more effective opioid alternatives to manage chronic pain, they say.