CDC Wants Medicaid to Restrict Access to Methadone for Pain

Medicaid recipients may soon see limited access to methadone for pain control.
Medicaid recipients may soon see limited access to methadone for pain control.

Methadone is in the hot seat again. Earlier this month, the Centers for Disease Control and Prevention (CDC) urged Medicaid to restrict access to the drug, citing that methadone – when prescribed for pain, not for opiate addiction – accounted for one in four prescription opioid deaths in 2014.

Methadone rose to popularity among certain physicians and clinics when they discovered so many patients abusing OxyContin prescribed to treat chronic pain. But soon after, those same doctors and clinics began to suspect their patients were equally abusing methadone.

Sure enough, the abuse rates for methadone when used to treat chronic pain had skyrocketed.

Examining the Link Between Medicaid and Methadone

Interestingly enough, the Medicaid community has been one of the hardest hit with methadone abuse. This is because methadone, in some states, can be prescribed without prior authorization – if it’s listed on that state’s preferred drug list (PDL).

This has proven to be problematic, as recent reports discovered a correlation between overdoses and accessibility to methadone. In fact, the rates of fatal and nonfatal methadone overdose among Medicaid enrollees in Florida and North Carolina – which treat methadone as a preferred drug not requiring prior authorization – were significantly higher than those in South Carolina, which doesn’t include methadone on their PDL.

“Given that methadone prescribing rates are higher among persons enrolled in Medicaid, strategies to reduce methadone prescribing among persons in this population might further reduce injuries and deaths from methadone,” according to a recent publication of Alcoholism and Drug Abuse Weekly. “Focusing on the differences between state PDLs, a comparative exploratory analysis of states with different methadone drug utilization management policies found an association between a state’s internal PDL policy and methadone overdose rates.”

Debatable Results

Despite the statistics, restricting Methadone among Medicaid recipients will, undoubtedly, be a controversial move. Proponents of its restriction may claim that other pain medications are available – medications that aren’t as addictive. Others may claim it’s unfair to punish an entire group just because a portion of them are abusing methadone. After all, there are many people on Medicaid who genuinely need the drug for chronic pain and have never abused it.

This restriction could also have far-reaching negative effects on the public’s view of methadone, whether it’s used for treating chronic pain or addiction. Only time will tell how – or if – this move by the CDC will actually yield results. Stay tuned…

Image Source: iStock

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