A new report by the Centers for Disease Control and Prevention suggests changes by insurance companies can make a dramatic difference in how many people receive potentially risky prescriptions for opioids that are helping fuel America’s heroin epidemic.
The prescription drugs, typically given for pain relief, can lead to dependence. Some people addicted to the pills switch over to other drugs like street heroin, which is becoming increasingly deadly. The problem runs deep: “In 2014, nearly 2 million U.S. residents either abused or were dependent on prescription opioids,” the CDC said.
The CDC report covers data in Massachusetts, where accidental opioid-related overdose deaths increased 45 percent in a year.
Blue Cross Blue Shield of Massachusetts put in restrictions that require doctors and patients both to sign off on a risk assessment; someone must also get pre-approval by the insurance company before getting the drugs. Quantity limits also bar first-time users from getting months-long supplies.
In the end, prescribing rate for all opioids decreased 14.7 percent, which doesn’t sound dramatic. The CDC said the average monthly number of prescriptions dropped by 14,000. What does that actually mean?
“Overall, the estimated quantity of opioids dispensed before and after implementation of the program indicate that approximately 21 million fewer opioid doses were dispensed in the first 3 years after implementation.”
The CDC recommends that opioids should not be the first-line therapy for chronic pain, and initial prescriptions should have limited quantities. The U.S. Surgeon General is also pushing to reduce opioid prescriptions.
Blue Cross also kept tramadol out of the program. Tramadol is thought to have a lower abuse potential than some other opioids. The data doesn’t suggest that tramadol was regularly substituted for the other other opioids, however. And the study doesn’t look at “how patient pain and function were affected by limiting access to opioid prescriptions.”