Editorial: Maine adds pain pill limits for Medicaid to cut supply
It has taken a while, but states are beginning to recognize that part of the prescription drug abuse problem is oversupply.
The high-powered painkillers that have fueled so much addiction and misery are meant for patients dealing with extreme pain. But clearly, some of these patients are getting more than they need.
The Center for Disease Control estimates that 55 percent of the painkillers being abused are given to the person by a friend or relative. Another 11 percent are sold to them by friend or relative. If the person with the original prescription is giving the pills away or selling them, they can't be hurting that bad.
Illegal doctor shopping adds to the problem, but so do the millions of pain pill prescriptions provided by Medicaid and other public health programs. That can be a particular concern for low-income states such as West Virginia and Kentucky, which not only have a big drug problem but also large Medicaid populations.
In fact, the CDC found that people on Medicaid are prescribed painkillers at twice the rate of non-Medicaid patients and have six times the risk of a prescription painkiller overdose.
Maine, another lower-income state with a big pill problem, has implemented new restrictions for its Medicaid program and reports some encouraging progress, The Associated Press reported last week.
MaineCare's new rules limit patients to painkillers for just two weeks a year, allowing renewal in two-week intervals with special permission. In some cases, smaller doses also are recommended. Patients with chronic pain lasting beyond eight weeks are required to try alternative pain management treatments.
Cancer and other patients with lasting pain from end-of-life conditions are exempt. Also, physicians can petition MaineCare on behalf of their patients if they think there is some special need.
The changes are credited with cutting the number of pills dispensed through MaineCare by 27 percent. The idea also seems to be rubbling off on doctors writing prescriptions through private insurance. That prescription volume is down, too.
It certainly makes sense for West Virginia, Kentucky and Ohio to go to school on these efforts. Not only are all three states in the top ranks for painkiller overdose deaths, but each state is expanding its Medicaid rolls with the implementation of the Affordable Care Act.
Prescribing smaller doses for shorter periods of time is a good idea. That should help prevent legitimate pain pill uses from turning into addiction and also reduce the volume of pills in the community.
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