(March 2012) Prescription Drug Abuse Project

http://www.nga.org/cms/Rx

The Prescription Drug Abuse Reduction Policy Academy is a year-long exercise in strategic planning aimed at reducing prescription drug abuse. In addition to Alabama and Colorado, five states – Arkansas, Kentucky, New Mexico, Oregon and Virginia – will develop and implement comprehensive and coordinated strategies that take advantage of all available tools and resources to address this growing problem.

Click to access 1409ReducingPrescriptionDrugAbuseReversingTheTrend_Marcucci.pdf

Under the governor’s directive, New Mexico started offering Medicaid reimbursement for Methadone and Suboxone in 2011 and 2012.

Sure, give the poor people methadone… and the state helps pay for it, too.  I wonder if the state of New Mexico also pays the families of those who have died from methadone?

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6126a5.htm

Vital Signs: Risk for Overdose from Methadone Used for Pain Relief — United States, 1999-2010

Vital statistics data suggest that the opioid pain reliever (OPR) methadone is involved in one third of OPR-related overdose deaths, but it accounts for only a few percent of OPR prescriptions… The overdose death rate for methadone was significantly greater than that for other OPR for multidrug and single-drug deaths.

[So, the cause of the problem wasn’t over-prescribing in at least one-third of opioid-related overdose deaths?]

In January 2008, on request of the Drug Enforcement Administration (DEA), manufacturers voluntarily limited distribution of the largest (40 mg) formulation of methadone to authorized opioid addiction treatment programs and hospitals only, because this formulation was not approved for the treatment of pain (6).

Data suggest that some of the current uses of methadone for pain might be inappropriate. According to an analysis conducted by FDA, the most common diagnoses associated with methadone use for pain in 2009 were musculoskeletal problems (such as back pain and arthritis) (46%), headaches (17%), cancer (11%), and trauma (5%). Most methadone prescriptions were written by primary care providers or mid-level practitioners (e.g., nurse practitioners) rather than pain specialists. Nearly a third of prescriptions appear to have been dispensed to patients with no opioid prescriptions in the previous month (i.e., opioid-naïve patients) (10).

The findings in this report are subject to at least five limitations…

Public and private insurers and health-care systems can ensure that prescribers of methadone follow dosage guidelines by requiring authorization for starting doses for pain that exceed the recommended upper limit of 30 mg per day (5). Insurance formularies should not list methadone as a preferred drug for the treatment of chronic noncancer pain. Pharmaceutical companies should introduce a 2.5-mg formulation of methadone to facilitate treatment with the lowest recommended dosage.

Well, it’s not bad enough that pain patients have the DEA acting as their doctors, but now also the allegedly bi-partisan CDC.

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