Keeping you updated on the latest Medicare and Part D news

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Opioid prescription patterns linked to likelihood of long-term use

A recent study has found that opioid days supply and the number of prescriptions in the first episode of opioid use can greatly affect the likelihood a patient will become an opioid chronic user.  The study examined a random sample of opioid-naive adults without cancer that received a prescription for opioid pain relievers.  Starting with the third day, the risk of becoming a chronic opioid user grows with each day additional day supply provided to patients.  Prescribing opioids is increasingly becoming a complicated decision for doctors to make.

FIGURE 1. One- and 3-year probabilities of continued opioid use among opioid-naïve patients, by number of days’ supply* of the first opioid prescription — United States, 2006–2015

	The figure above is a line chart showing 1- and 3-year probabilities of continued opioid use among opioid-naïve patients, by number of days’ supply of the first opioid prescription in the United States during 2006–2015.

* Days’ supply of the first prescription is expressed in days (1–40) in 1-day increments. If a patient had multiple prescriptions on the first day, the prescription with the longest days’ supply was considered the first prescription.


FIGURE 2. One- and 3-year probabilities of continued opioid use among opioid-naïve patients, by number of prescriptions* in the first episode of opioid use — United States, 2006–2015

	The figure above is a line chart showing 1- and 3-year probabilities of continued opioid use among opioid-naïve patients, by number of prescriptions in the first episode of opioid use, in the United States during 2006–2015.

* Number of prescriptions is expressed as 1–15, in increments of one prescription.



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15 maps and charts visualizing the opioid epidemic in the United States has compiled 15 maps, charts, and graphs that visually depict the opioid epidemic that affects millions of Americans annually. Highlights and a link to the source below:

Chart showing that the number of days an opioid is prescribed matters for curtailing continued use

Chart showing that the number of Americans reporting chronic pain has increased from 1998 to 2010.

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Risk of chronic opioid use in elderly impacted by prescribing doctor

A recent study has found a link between chronic opioid use in Medicare beneficiaries and “high-intensity” prescribers, doctors that prescribe opioids for one in four patients they treat.  Beneficiaries with a high-intensity prescriber were 30% more likely to become a long-time opioid user.  Study authors conclude that their results are indicate that a single opioid prescription can affect the chances of long-term use and additional adverse health outcomes among elderly patients though additional research is needed.

The New England Journal of Medicine

New York Times


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Widespread Use Of Prescription Drugs Provides Ample Supply For Abuse

A federal survey published Thursday found that about 45 percent of the individuals 12 and over take prescription psycho-therapeutic drugs, amounting to 119 million Americans. Misuse of prescription psycho-therapeutic drugs is second only to marijuana as the nation’s most prevalent illicit drug use issue.

Organizations, such as the CDC and SAMHSA, are working on two main solutions: (1) creating better prescribing practices to lessen the availability of the drugs; and (2) expanding substance abuse treatments to increase affordability and accessibility.

The widespread availability of these drugs poses issues with the misuse of these drugs. Only 5 percent of survey respondents bought drugs from a dealer or stranger, the vast majority misused their own prescriptions or obtained drugs from family or friends. This misuse amounts 16 percent of all prescription drug use, a result of a prescribing system that promotes overuse and abuse.

A secondary issue is the lack of affordable and accessible treatment options. Many of these psycho-therapeutic drugs have addictive properties. Only 8.3 percent of individuals need substance abuse treatment, but only 1- percent of these individuals people receive the treatment that can help them to recover.

NPR Article


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DEA Expands Prescription Drug Take-Back Efforts

The Drug Enforcement Agency (DEA) will soon allow hospitals, drug manufacturers, pharmacies, and other authorized entities to take back prescription controlled substances. These organizations, as well as law enforcement, can voluntarily maintain collection receptacles and administer mail-back programs. Before this change, people could either dispose of unused drugs themselves (which poses environmental concerns), or return them to police stations in one of the DEA’s semi-annual prescription take-back events.

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DEA Reclassifies Hydrocodone Combination Products As Schedule II Drugs

The Drug Enforcement Agency released a new rule reclassifying hydrocodone combination products as Schedule II drugs. Previously, only pure hydrocodone drugs were considered Schedule II, while hydrocodone combination products were classified as Schedule III because it was believed that mixing hydrocodone with non-narcotic painkillers such as acetaminophen would reduce their potential for abuse. The policy change will take effect in 45 days, and will place stricter rules on how doctors can prescribe hydrocodone combination products. 


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FDA Approves Abuse-Deterrent Opioid

The FDA recently approved Targiniq ER, a painkiller that contains both oxycodone, a powerful opioid, and naloxone, which is used to prevent fatal opioid overdose. When swallowed intact, the naloxone component of Targiniq ER stays dormant. However, when the pill is crushed, the naloxone component is activated and prevents the oxycodone from binding to brain receptors to provide pain relief. Though people could still become addicted or overdose when using the drug as intended, Targiniq ER limits the common abuse delivery routes such as injecting or snorting crushed pills.