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As the endless political battle over healthcare reform rages on, there is at least one thing everyone can agree on: fighting the opioid epidemic.
The CDC and the FDA recently announced more funding and tools that states can use to stem the tide of opioid overprescribing and overdoses, while states are moving to curtail the amount of opioid prescriptions any way possible.
The FDA has asked the National Academies of Sciences, Engineering, and Medicine (NASEM) to compile a report on the latest science of opioid abuse and pain management as part of the agency’s 2016 Opioids Action Plan. Drug overdose is the leading cause of unintentional injury death in the United States, according to NASEM. The report includes recommendations for the FDA and other agencies to find a balance between reducing opioid misuse and abuse and ensuring patients with chronic pain have access to responsibly prescribed medications. Strategies include reducing demand, using medication-assisted addiction treatment, increased FDA oversight of drug risks and benefits, and further research of opioid dependence and the mechanisms of chronic pain.
The CDC this week awarded $12 million in grants to 23 states and the District of Columbia to stem the tide of opioid overdoses and give patients the help they need, with plans for additional funding to be awarded in late summer. Calling the epidemic “a scourge on our nation that knows no bounds,” Department of Health and Human Services Secretary Tom Price, MD, said in a statement that the agency is “working to support states on the front lines of this national crisis. This new support from CDC, funded by the appropriations bill President Trump signed in May, will help states and local authorities track this epidemic and respond in real time.”
The CDC also is awarding funding to states that applied for assistance through the Enhanced State Surveillance of Opioid-Involved Morbidity and Mortality program. Thirty-two states and the District of Columbia will receive $7.5 million to develop more robust surveillance and tracking of overdoses and share data with the CDC. Eight other states will receive funding to improve and implement prescription drug monitoring programs.
Some states have focused efforts on reining in the number of opioid prescriptions. Health First Colorado, the state’s Medicaid program, announced last week it is limiting the amount of opioids prescribed to plan members who have never received a prescription or have not received one in the last 12 months. Members will receive one seven-day supply of painkiller as needed and may request two additional seven-day refills. A fourth refill would require prior authorization of the state’s Department of Health Care Policy and Financing, with the potential for a pain management consultation from the Drug Utilization Review board. Members who are currently on a pain management plan will taper down to 250 morphine milligram equivalents (MME) per day, from 300 MME per day. Patients in palliative care, hospice care, or cancer care are exempt from the restrictions.
“The policy was developed following a department analysis of claims data showing a growing number of Health First Colorado members who have not taken opioids before — or have not taken them for up to one year — once they start opioids go on to using them more frequently,” according to a statement from the Department of Health Care Policy. “The department wants to ensure members have appropriate medication to treat their pain, without excessive doses that are not needed.”