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Pain Meds and The Opioid Epidemic: 10 Things To Know

There’s a lot in the news these days about what’s referred to as the opioid crisis or epidemic.

Just yesterday for instance —  highly respected healthcare consultant (and close friend) Joe Paduda, fresh off of speaking at a national drug summit in Atlanta, wrote an insightful but grave piece on the impact of opioid abuse for Managed Care Matters. Joe nets out the massive increase in the death toll stemming from prescription pain killers (opioids) and how the increased use of heroin has been driven by users who started with prescription opioids .

And, in an article appearing in Thursday’s Wall Street Journal (The Accidental Deadly Drug Prescription) a Baltimore physician writes how doctors and patients alike are unaware of the threat of accidental death posed when opioids interact with other frequently prescribed drugs.

Got me thinking. Despite all the news, despite being in a healthcare related field and working with prescription drug plans, and despite having had family, friends, and colleagues at work touched by this crisis, I realized I don’t really know nearly enough about the overall issue. I wanted to better comprehend the basics and so I dug in a little bit to get a better grasp. Thought I’d share in case you’re in the same boat as me.

Here are 10 things about the growing pain med problem that may help you better understand:

1.) Per the National Institutes for Health (NIH), Opioids are medications that relieve pain. They reduce the intensity of pain signals reaching the brain by diminishing the effects of a painful stimulus. In other words, they reduce the patient’s perception of pain.

2.) Medications in the opioid class include hydrocodone (e.g., Vicodin), oxycodone (e.g., OxyContin, Percocet), morphine (e.g., Kadian, Avinza), codeine, and related drugs.

 3.) Hydrocodone products are the most commonly prescribed for a host of painful conditions, including dental and injury-related pain.

 4.) Morphine is often used before and after surgical procedures to alleviate severe pain.

 5.) Codeine is often prescribed for mild pain. In addition to their pain relieving properties, some of these drugs—codeine and diphenoxylate (Lomotil) for example—can be used to relieve coughs and severe diarrhea. (In other words, just about anyone could have been prescribed an opioid at one time or another.)

 6.) Addiction may develop due to the euphoric response some people experience when taking opioid medications. The drugs affect the brain regions involved in reward. Those who abuse opioids may look to step up and intensify their experience by taking the drug in ways other than those prescribed or switching to heroin after becoming addicted because heroin may be less expensive and or more easily accessible.

 7.) Over the course of almost two decades overprescribing of opioids has led to a huge increase in the frequency of opioid addiction. This in turn has led to the steep rise in overdose deaths and increased heroin use. Use of hydrocodone has more than doubled and consumption of oxycodone has increased by nearly 500%. The number of deaths due to opioid overdose death nearly quadrupled.

 8.) This acceleration in the prescription and use of opioids was fueled in large part by the combination of the introduction of OxyContin in 1995, more aggressive identification and treatment of pain, and, an overall increase in emphasis on Pain Management as a treatment modality.

 9.) The group with the highest death rate from opioid prescription pain meds is the 45-to-54 age group — more than four times the rate for teenagers and young adults. The rate of overdose deaths for adults ages 55 to 64 has soared sevenfold.

 10.) Everyday 46 Americans die from using prescription painkillers.

I guess my take away is for me to tune in more. And, encourage our team and our clients and their employees to tune in more.  Maybe at one time it seemed mostly just on the streets. Not any more. It’s at the office; it’s at home; and it’s over the roads. From classrooms to locker rooms to board rooms, pain med addiction has become a real and costly issue that in some way shape or form has touched most of us.

HHS Publishes Out-of-Pocket Regs for 2017

This is hot off the presses. The most important announcement this past week is that HHS published the increased out-of-pocket regulations for 2017. Originally, the ACA was to cap deductibles at $2,000. That seems like a long time ago and was never really followed.

In the big picture, this increase seems to indicate that they see costs continuing to increase and consumers will need to consider mitigating those increases by moving to higher deductible plans.

Rx Shock: Ever Faced A 900% Increase Nearly Overnight? You’re Not Alone.

We are finding some crazy Rx trends that are translating into real world cost and care issues for our clients and their employees. Here’s a prime example. We recently found that a type 2 diabetes drug (GLUMETZA) increased in cost by 900%, nearly overnight.

After digging into it here’s what we found:

• An investment firm purchased the manufacturer
• The price of the drug quickly spiked under the new ownership
• The drug had a specific efficacy but was prescribed widely

Quietly Lurking: 2017 Obamacare Waiver Could Open the Door for States to Do Their Own Thing

We’re keeping an eye on it; and, apparently so are many of the states. The healthcare reform law includes a waiver that, starting in 2017, would let states take federal dollars now invested in the implementation of the Affordable Care Act and redirect them and redesign their own health care systems.

Some elements of the law could not be repealed, such as the requirement that insurance companies provide coverage regardless of pre-existing health problems. But they could replace the law’s unpopular mandate that requires virtually everyone in the country to have health insurance, provided the alternative worked reasonably well.

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