Will America’s $133M Opioid Abuse Solution Overlook Patients?

February 10, 2015

by Amanda Conschafter, blog editor

President Obama’s 2016 fiscal year budget throws big money at one of America’s biggest public health challenges: opioid abuse.  The president’s budget allocates $133 million for the Department of Health and Human Services to combat pain pill and heroin abuse, signaling the issue’s growing urgency. Meanwhile, several states are eyeing abuse-deterrent opioid formulations to fight the problem at home. But as recent civil rights complaints reveal, policymakers must consider the costs of combatting abuse broadly – including the unintended consequences for patients with legitimate medical need.

The president’s budget seeks to reduce abuse rates through several tactics. The proposal would increase funding to states with prescription drug monitoring programs and expand treatment for abusers, says Forbes.com.   The proposal also seeks to make anti-overdose drug naloxone more available to first responders.

State lawmakers, meantime, are debating legislation on how to encourage abuse-deterrent forms of opioid pain medications. To make these forms widely available, insurers must provide coverage for the new and sometimes costly technology. Therefore, some state bills require insurers to include abuse deterrent formulations in their drug formularies and to provide them coverage equal to that for non-abuse deterrent forms. Other bills prohibit pharmacists from swapping a prescribed abuse-deterrent pill for a non-abuse deterrent form unless the prescribing physician approves.

These efforts could help to limit abuse. But, as a recent American Civil Liberties Union lawsuitsuggests, patients’ rights deserve equal attention.

Earlier this year the ACLU challenged the state of Indiana for requiring patients who are prescribed a certain level of pain medication to submit to annual drug testing. Interpreting the requirement as an “unreasonable search,” the ACLU charged the state with violating patients’ Fourth Amendment rights.

In response, the state Medical Licensing Board removed the requirement. Physicians can now administer drug tests at their discretion based upon medical necessity. But the scenario sheds light on how even well intentioned efforts to curb abuse can infringe upon patients’ rights.

Thus, as both federal and state entities look for solutions, they must maintain a delicate balance: addressing the problem of abuse while protecting access for everyday patients living with pain.

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