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Curbing Opioid Over-prescriptions to Help End the Cycle of Addiction

Posted 03/23/2018

Aspenpointe is a skilled organization that is committed to ending the cycle of substance abuse through counseling and treatment of addiction. There are multiple fronts on which this battle can be fought. One through effective treatment for those who suffer with addiction and second through the way people tend to become addicted.

Out of the 98 million people in the United States who have opioid prescriptions every year, around 3 million receive multiple prescriptions from 5 to 20 different physicians in an all to common practice referred to as “doctor shopping”.

This dangerous practice allows those addicted to opioids a way to indulge their addiction by taking way too many of these pills with help from doctors who are unaware that the patient is playing with fire. Doctor shopping also plays a roll in the black-market for drug dealers to take advantage of health care to add another product to their repertoire.

Although opioid treatment is vital to a person wishing to recover, creating a thorough process to slow addiction rates is another thing insurers can do to slow its progression.

Medicaid has taken note and has adopted measures that have reduced the problem. One way to combat this issue is if other insurers take note of Medicaid’s plain fiscal policies to reduce opioid overdoses and dependency from “Doctor shopping”.

Through doctor shopping with a typical large insurer, prescriptions go unnoticed as there are multiple doctors who are unaware of the other prescribers out there. On the flip side what Medicaid has done is created an ability to examine medical billings for those enrolled in the plan and identify prescription shoppers. If a person is identified in this category then the insurer adds a reimbursement lock-in, which means the insured will only be covered if the prescriptions are written by a single doctor.

Paying out of pocket hurts the opioid dependent patient financially and reduces the ability to become addicted. Medicaid has also shown that the number of prescriptions has decreased.

Although reimbursement lock-ins can be avoided, for instance those with multiple insurance coverage plans like those with Medicaid and Medicare, it will become increasingly harder in 2019 when Medicare plans on instituting reimbursement locks as well.

If private insurers take note of this program the dependency on opioids would become more difficult. Other smaller insurance companies are taking note of the opioid epidemic.  Through full reporting compliance and methodologies with prescription dispensing control the doctors that work with DocRX for example, have keen visibility on patient habits, orders and education to reduce the risk of dependency and can offer alternatives. Hopefully more insurers follow suite. The technology used for example, allows their proprietary software to run reports on prescription habits of controlled medications vs non-controlled and goes as far as letting them know if a dispensing patient has gotten medications at another location.

By incorporating a multi-tiered approach to reducing and educating patients, using technology to our advantage, along with reimbursement lock-ins the ability to reduce dependency is effective in fighting this issue.

There has been a strong call as of late from the Bipartisan Coalition of 37 Attorney Generals to examine the financial incentives that have resulted in over-prescription. Further, the current Attorney General, Jeff Sessions has unveiled a new task force that is targeting opioid manufacturers to understand and reduce the risks of opioid addictions.

There are also a few lawsuits being considered against manufacturers for deceptive advertising practices that are misleading the public.  Public officials are starting to understand the scope of the opioid epidemic and with lasting legislation the appeal to curb this issue has grown.

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