(Hood River, Ore.) -- “This is an accelerating public health crisis,” said David Russo, D.O., of the Columbia Pain Management Clinic in Hood River, and local expert, regarding the sharp increase in abuse of prescription drugs, specifically opioids and benzodiazepines. Oregon is ranked 4th in the nation for prescriptions written of long-acting opioids.
Dr. Russo and several fellow physicians assert that the need to address such drug abuse is timely and that proposed legislation can help address this problem. He points to a report released last week from the U.S. Department of Health and Human Services that calls attention to deaths from drug overdoses, the number of which has risen steadily over the past two decades, becoming the leading cause of injury death in the United States.
Oregon also ranks 16th in the U.S. for prescriptions written for high dosages of opioids.
Senate Bill 661 seeks to help efforts aimed at halting prescription drug abuse by asking insurers to provide equitable coverage of new ‘smart pills.’ These new FDA-approved opioid pain medicines are known as Abuse Deterrent Formulations because they prevent the opioid from being abused, thereby reducing or eliminating the factors that lead to addiction. The mechanism of these formulations render certain pain medications − those that are highly addictive and often abused such as opioids and benzodiazepines− completely inactive when their form is altered.
‘Smart pill’ medications with abuse deterrent formulations contain physical or chemical properties that can prevent chewing, crushing, cutting, grating, grinding, or dissolving. Abuse deterrent medicines can also be made to create aversion, which is when substances are combined to produce an unpleasant effect if the dosage is manipulated prior to ingestion or a higher dosage than directed is used.
“We believe that Senate Bill 661 is a responsible bill, as it seeks parity in asking insurers to cover these abuse deterrent medicines equivalent to how opioids without the deterrent technology are covered,” said Dr. Russo, who is leading the testimony in support of the measure at Wednesday’s Senate Committee on Health Care hearing at 3 p.m. in Hearing Room A.
Senate Bill 661 also ensures that an insurer may not increase the lowest cost-sharing level imposed on drugs covered by the plan, or create financial disincentives for prescribers and dispensers to prescribe or dispense abuse deterrent opioid analgesic drug products.
Prescription drugs, especially opioid analgesics—used to treat both acute and chronic pain— have increasingly been implicated in these deaths. From 1999 to 2013, the rate for drug poisoning deaths involving opioid analgesics nearly quadrupled.
“Toxic overdoses and deaths resulting from opioid abuse and misuse is a problem that is plaguing our communities—especially, in my experience, communities with fewer health resources and rural parts of our state,” said Dr. Russo. He adds, “In fact, according to the Oregon Center for Health Statistics and Vital Records, more Oregonians die from prescription drug overdoses than from heroin and cocaine combined.”
“People living with health conditions, which cause short-term or chronic pain, can and do benefit from traditional opiate pain medications in immediate and time-released formulas,” said B.J. Cavnor, HIV patient and executive director of 1 in 4 Chronic Health Collaborative. He adds, “Unfortunately these drugs are widely prescribed, and also widely abused.”
“Currently is it very difficult to get medication with abuse deterrent technology approved by insurance companies, but this technology will help decrease diversion of narcotics,” said Carl Erickson, D.O., of Cascade Family Practice.
“As a practicing pain physician treating this significant patient population, I believe that abuse deterrent formulation of opioid medications is a long overdue necessity,” said Oleg Maksimov, M.D., president of Columbia Pain and Spine Institute. “It is not and should not be even an option to allow our community to be exposed to all risks of medication abuse if safer options are available.”
“While there is great concern and action to reduce abuse and addiction, access to pain medications for patients must be preserved,” said Jan Chambers, president and founder, National Fibromyalgia & Chronic Pain Association. “Understandably and as expected, abuse deterrent formulations have been shown to increase patient and public safety.”
“In a study of data from 2010-2011, Oregon ranked number one in nonmedical use of prescription pain relievers, according to the National Survey on Drug Use and Health,” said David Walls, executive director of the Osteopathic Physicians and Surgeons of Oregon. He added the Centers for Disease Control and Prevention has classified prescription drug abuse as an epidemic.
Kevin Kane, D.O. an Oregon physician who focuses on physical medicine and rehabilitation, said, “The protection afforded by abuse deterrent technology should not be effectively denied to my patients by cumbersome prior authorization procedures or, worse yet, exclusion or denial of the medications I choose to prescribe in a given situation.”
