Prescription Opioids Covered by Medicare
March 29, 2018
Is putting limits on prescription painkillers the answer to the American opioid addiction epidemic? Would thresholds on prescription opioids reduce the number of people who are, or would become, opioid addicts? Both of these questions are worth asking, but they are not easy to answer for myriad reasons.
First and foremost, patients struggling with pain need to be able to rely on their primary care physician for relief. As you are probably aware, the go-to solution, historically, is prescription opioids like OxyContin, Vicodin, and Percocet. While there are alternative forms of pain management available, i.e., exercise and physical therapy, most doctors prescribe painkillers either way.
The cons of prescription opioids are many, not the least of which is the risk of addiction and overdose. What’s more, there is a growing body of evidence suggesting that physicians should only rely on pain narcotics as a last resort. Research shows that patients taking over-the-counter (OTC) meds find about the same level of relief that opioid users experience. So, if prescription opioids are not all that effective and carry the risk of significant harm, perhaps it justifies changing course regarding prescribing practices.
Medicare Combats Limits Access to Prescription Opioids
If you have been following the news recently, perhaps you have seen headlines regarding Medicare and overprescribing. Research shows that one in three of 43.6 million beneficiaries had been prescribed opioid narcotics in 2016. The above figure is both hard to believe and is, sadly, the status quo in that U.S. Doctors rely on opioids far too often, despite the risks that patients face every time they swallow a pill.
Medicare officials have chosen to take a new stance on how they will cover specific opioid prescriptions. In fact, starting April 2nd, the federal insurance program will no longer cover the cost of long-term, high-dose prescriptions for patients, The New York Times reports. The rule would not apply to patients with cancer or those in palliative care facilities.
While the decision has been met with staunch opposition, the practice is not new; in fact, around 24 states and many private insurers have caps on prescription opioids, according to the article. The new Medicare rule would also serve to identify physicians who overprescribe and patients who “doctor shop.”
Some critics of the new coverage policy contend that it will cause patients to experience withdrawal; and, left with no other option, such people will look to the streets for relief. Given the prevalence of fentanyl found in illicit opioids, pain management could come at a fateful cost.
A letter of opposition was penned by Dr. Stefan G. Kertesz, a professor of addiction medicine at the University of Alabama at Birmingham, the article reports. Some 220 professors in academic medicine, addiction treatment and pain management experts, and patient advocacy groups signed the letter.
“A lot of the opioid dose escalation between 2006 and 2011 was terribly ill advised,” says Dr. Kertesz. “But every week I’m trying to mitigate the trauma that results when patients are taken off opioids by clinicians who feel scared. There are superb doctors who taper as part of a consensual process that involves setting up a true care plan. But this isn’t it.”
Opioid Addiction Treatment
Christians Drug Rehab can help you or a loved one begin the journey of opioid use disorder recovery. Our faith-based treatment center will assist you to reconnect with God and provide you with tools for leading a productive life in recovery.