Maine Medicine Weekly Update - 04/23/2018 (Plain Text Version)
In this issue:
Opioid Prescribing for Pain Continues to Decline in Maine
Prescribing of opioid medication continued to decline substantially in Maine based on nationwide data released last week by the American Medical Association in cooperation with the health data information firm IQVIA. Opioid prescribing for pain declined 32% from 2013 through 2017 while 22.2% fewer opioid prescriptions were filled nationally.
The decline in Maine was 13.3% in 2017 alone. Every state in the nation has shown a significant reduction in opioid analgesic prescriptions since 2013 and every state showed a decline in the last year.
In 2017, a total of 196,001,292 opioid prescriptions were filled in the USA, representing an 8.9% decrease from the prior year - the sharpest 1-year decrease observed. Many states with the most profound opioid abuse problems, such as Maine and New Hampshire, have exhibited the greatest decline in opioid prescribing. Four other states, including New Hampshire, joined Maine in achieving decreases of over 30% since 2013. Earlier this month, President Trump, speaking in New Hampshire, set forth a goal of decreasing opioid prescribing by one-third over three years. Maine and New Hampshire are already there.
At the national level, roughly one-half of opioid prescriptions were paid by commercial plans. Another one-third were paid by Medicare Part D. The remainder were split almost evenly between Medicaid and cash.
"There is no doubt that Public Law 2016, Chapter 488 is responsible for much of the decrease," noted MM EVP Gordon Smith. "But the fact that prescriptions of opioid analgesics declined in all fifty states clearly demonstrates that other factors are impacting prescribing as well, including no doubt educational efforts."
In responding to the release of the data the AMA released the following statement attributable to Patrice A. Harris , M.D., MA, chair of the AMA Opioid Task Force:
“A 22-percent decrease in opioid prescriptions nationally between 2013 and 2017 reflects the fact that physicians and other health care professionals are increasingly judicious when prescribing opioids. It is notable that every state has experienced a decrease, but this is tempered by the fact that deaths related to heroin and illicit fentanyl are increasing at a staggering rate, and deaths related to prescription opioids also continue to rise. These statistics again prove that simply decreasing prescription opioid supplies will not end the epidemic. We need well-designed initiatives that bring together public and private insurers, policymakers, public health infrastructure, and communities with the shared goal to improve access and coverage for comprehensive pain management and treatment for substance use disorders.
“Additionally, it is a sign of progress that IQVIA reported an increase in new treatment starts for medication assisted treatment (MAT) for patients with opioid use disorder, nearly doubling from 44,000 in December 2015 to 82,000 in December 2017. This evidence-based treatment can slow and even stop this epidemic. Physicians and other stakeholders accept that bold action is needed. We go where the evidence leads us. We all must take care that policies and practices don't restrict access to one alternative for pain relief without increasing access to comprehensive, multidisciplinary pain care, including non-opioid-based options."
In 2015, the AMA launched a Task Force to Reduce Opioid Abuse and continues to work with state medical societies to address legislation and regulation ranging from developing effective prescription drug monitoring programs, continuing medical education, restrictions on treatment for opioid use disorder as well as enactment of naloxone access and Good Samaritan overdose protections.