In last 20 years opioids abuse and addiction has reached dramatical proportions. Painkillers prescribed and street drugs caused more deaths than gun violence or car accidents. Web-site TheCrisisNextDoor – a project of White House, where anybody who suffered and overcame addiction or helped others to do so, can share a video with their story. The site states: “In 2018, more than 2 million Americans will suffer from addiction to prescription or illicit opioids.” Centers for Medicare and Medicaid Services (CMS) cannot stay aside.

The published roadmap outlines the efforts to address the issue. Even though some progress has been made, still the situation is critical. The first important thing is to spread the info and let people know that there are treatment options and they are not alone with their problem.

According to Centers for Disease Control and Prevention (CDC) data during 2016, there were more than 63,600 overdose deaths in USA and 66.4% - an opioid overdose death. That is almost 116 people a day. It’s horrible!

For sure, used correctly and on time, prescribed opioids are helpful for pain relief and CDC created guidelines for safe prescribing. But misuse, abuse and finally – addiction still happens very often. Sad statistics – only 20% of people with opioid disorder receive addiction treatment.  

PREVENTION

First line of pain relief must be safe range of treatment. Opioids usage must be the final option after all applicable medications/treatments. Before planning a surgery physicians advised to talk to their patients and create a pain-management strategy. There are many pain relief options, which are non-opioids – “safe” medications, intravenous patient-controlled analgesia, local and regional anesthetics, even non-medication options like electrical stimulation. 

TREATMENT

The goal is to expand the access to opioid use disorder treatment. This treatment includes individual and group counseling, inpatient and residential treatment, intensive outpatient treatment, partial hospital programs, case of care management, medication-assisted treatment, recovery support services and peer supports.

DATA

Collected data used to determine prevention and treatment options and target fraud and abuse. CMS released data in 2017 and 2018 to show where the high level of opioids prescribing is to help identify potential risks. It is very important to understand the patterns of opioid misuse and abuse across population.

• Continue reducing overprescribed opioids.
• Incorporate incentives for appropriate prescribing into future Medicare Quality Star Ratings and the Quality Payment Program.
• Align monitoring of systemic overprescribing to CDC guidelines and partner with law enforcement to stop egregious prescribers.
• Disseminate best practices for state Medicaid agencies and other payers on alternative pain management strategies and other tactics to address the opioid crisis.
• Identify and develop solutions for treatment barriers for pain and opioid use disorders across Medicare, Medicaid, and private health plans.
• CMS will focus our data efforts and provide tools for states, plans, and providers in order to monitor success of prevention measures, improve data transparency, analyze prescription opioids use patterns and support state Medicaid program capacity to track and report data.

More details can be found here.

OPIOID PRESCRIBING AND PAIN MANAGEMENT UPDATES 

According to bill #2735 introduced on June 18, 2018 pain management clinics would have to be licensed in New Jersey. It also modifies requirements for opioid-prescriptions and medication-assisted treatment, authorizes use of non-opioid advance directives by patients and establishes process to identify abnormal drug usage and prescribing practices. The bill responds to a growing painkiller epidemic in the state, including sleazy pain clinics that freely spoon out insurer-funded pain meds to addicts.

The full version of the bill is here: Senate, No 2735.