Heroin and prescription painkiller abuse are costing the U.S. thousands of lives and billions of dollars each year, but new steps taken Wednesday by the feds, officials hope, may begin to slow those skyrocketing numbers.
The Department of Health & Human Services just announced five new actions it is taking to address the nation’s opioid epidemic. These include expanding doctors’ ability to dole out medications to treat opioid-use disorder, along with eliminating any perceived financial incentives for physicians to prescribe such painkillers, and launching more than a dozen new studies about this man-made health crisis.
The numbers tied to the epidemic, as outlined in this new HHS fact sheet, are staggering. More than 165,000 people died from just prescription painkiller overdoses between 1999 and 2014. About 78 people die from all opioid-related overdoses (including heroin) every day, and the epidemic is costing our country $55 billion each year in health and social costs. These figures illustrate why addressing opioid overuse in America is so vital, and why Congress must provide the necessary $1.1 billion requested by the president to address it, HHS believes.
“The opioid epidemic is one of the most pressing public health issues in the United States. More Americans now die from drug overdoses than car crashes, and these overdoses have hit families from every walk of life and across our entire nation,” Secretary Sylvia Burwell said in a statement. “At HHS, we are helping to lead the nationwide effort to address the opioid epidemic by taking a targeted approach focused on prevention, treatment and intervention. These actions build on this approach.”
Here is a quick look at the five aspects of Wednesday's HHS announcement:
- Expanded access to buprenorphine: A new rule, finalized Wednesday by the Substance Abuse and Mental Health Services Administration, will allow clinicians to prescribe more of the opioid-use disorder drug buprenorphine. Previously, practitioners could only prescribe this medication-assisted treatment to up to 100 patients, but now eligible providers can obtain a waiver to treat up to 275.
- Addressing HCAHPS: Hospitals and docs previously have expressed concern that patient satisfaction surveys have indirectly forced them to write more prescriptions for opioids. To address even the perception that there is financial pressure to up such orders, the Centers for Medicare & Medicaid Services is proposing to remove any pain management questions from the HCAHPS survey.
- Harnessing tech: Starting today, the Indian Health Service, a division of HHS that provides care to Native American and Alaskan peoples, will begin requiring prescribers to use their state’s prescription drug monitoring programs. The database will allow the 1,200-plus IHS clinicians to improve pain management and identify those patients who have an opioid-misuse problem or may be diverting drugs.
- Filling research gaps: HHS is launching more than a dozen new studies tied to opioids with the goals of developing new addiction treatments, identifying evidence-based pain management methods and reducing the misuse of these drugs, to name a few. The agency also issued new documents Wednesday, cataloguing current studies, and outlining its research priorities.
- Safer prescribing: Finally, the department is seeking out better ways to educate providers about properly prescribing opioids. HHS already has developed a number of activities in this regard, but is issuing a request for comment on those practices to see if there is any way it can strengthen them.
Industry groups, such as the American College of Emergency Physicians and American Medical Association, applauded Health & Human Services actions Wednesday afternoon. ACEP, for one, says modifications to patient satisfaction surveys will help its members in their mission to curb opioid prescribing. More than 1,000 patients show up at hospital emergency departments every day for opioid-related treatment, and the nation spends some $20 billion in ED and inpatient care for opioid poisonings each year.
“The pursuit of high patient-satisfaction scores can create incentives for medical providers to honor patient requests for unnecessary and even harmful treatments,” ACEP President Jay Kaplan, M.D., said in a statement. “The HHS proposal will align federal policies to be consistent with current efforts to reduce opioid use.”
The AMA also commended modifications to patient satisfaction surveys, while also expressing its support for expanding medication assisted treatment methods, such as buprenorphine.
“The AMA applauds the critical steps announced today by Secretary Burwell to attack the opioid epidemic that is ravaging communities of all shapes and sizes across our country,” AMA President Andrew Gurman, M.D., said in a statement. “Medication-assisted treatment is proven effective but, for too long, too many patients have lacked access to this treatment. Today’s final rule is an important step that nearly triples the number of patients practitioners may treat with a waiver, but more must be done to leverage trained physicians to close the treatment gap.”