Pennsylvania Expected To See Significant Decrease In Opioid Prescriptions in 2017
In 2016, Pennsylvania officials and lawmakers finally made progress toward curbing the mass writing of opioid prescriptions, a trend long thought a contributor to the nation’s sharp increases in opioid-related deaths. Indeed, it appears the trend of over-prescribing may already be on the decline.
That is, the latest data shows that increased awareness of the issue may be prompting health providers to take pause. More conservative prescribing practices has been evidenced in Pennsylvania and in many other states in the U.S.
Physician General Rachel Levine:
“I think that our message is getting out, and I think there is the beginning of a change in prescribing culture. There is evidence that there has been, both in Pennsylvania and nationally, less prescribing for opioids by physicians and other health care providers.”
Highmark Data And Efforts
Highmark, a private healthcare company based in Pittsburgh, revealed data that showed the number of opioid prescriptions it reimbursed in the last 3 months was lower than in any of the prior 9 months.
Officials at Highmark say they are currently working to identify and treat patients with mental health conditions that can lead to substance abuse.
In West Virginia, the company has commissioned Axial Healthcare to analyze its data for evidence of over-prescribing, with intent to facilitate discussions with providers about appropriate prescribing guidelines.
If successful, Highmark may expand this approach to Pennsylvania.
The University of Pittsburgh Medical Center Data And Efforts
According to the Associated Press, the University of Pittsburgh Medical Center reported that 16% of its insured population received at least one prescription opioid in 2016 – a number down from 20% the previous year.
The UPMC Health Plan reported that it is using an algorithm intended to identify patients at risk for opioid addiction. In addition, they are in the process of training doctors to use complimentary pain management approaches.
A New Trend?
Given the initiatives of Highmark and UPMC, this year we are expected to witness a decline in opioid prescriptions – an upward trend that has persisted until quite recently.
In Pennsylvania’s east, prosecutor collaboration with the DEA and FBI have been filing criminal charges against over-prescribing physicians.
For example, former Philly physician Jeffrey Bado was found guilty this month of more than 300 felony counts, including one which resulted in a death.
In addition, the state Board of Medicine and Board of Osteopathic Medicine acted this year against the licenses of 18 Pennsylvania physicians accused of over-prescribing opioids. This was a bold move, considering that between 2011-2015, such actions only averaged about 11 per year (a number much lower than many other states.)
Indeed, a Pittsburgh Post-Gazette report from May revealed in the last 5 years, more than 600 healthcare providers were disciplined for their prescribing practices in 7 states around Appalachia, but that measures taken by Pennsylvania were the fewest of any state in the region.
New Laws And Guidelines
In October, Gov. Wolf signed laws passed by the General Assembly aimed to increase disciplinary action against physicians who over-write prescription opioids.
For one, healthcare providers are disallowed from prescribing more than a week’s worth to minors, unless the need is thoroughly documented. In addiction, emergency medical practitioners will be privy to similar restrictions.
In 2017, medical schools will also be required to include appropriate curriculum regarding the prescribing of opioids. Doctors will also need to attend biennial refresher courses related to the dangers of painkillers and prescribing practices.
Also, physicians intent on prescribing opioids or benzodiazepines will be required to check the patient’s history using a prescription drug monitoring database.
If the database reveals that the patient is “doctor shopping” (getting prescriptions from several sources) the physician can refer them to rehab.
These databases are now implemented in most states, but many are not mandatory for prescribers to use. And unfortunately, these databases do not connect to neighboring states, so users may still be able to obtain multiple prescriptions across borders. Dr. Levine noted that Pennsylvania has plans to link the database to nearby states, but there is no set timeline for this to go into effect.
It is nearly certain that changes implemented in 2017 will contribute to the slowly decreasing availability of opioid prescriptions. However, the rash of heroin and fentanyl overdoses are not expected to sharply decline any time soon. Those already addicted still require identification, assessment and treatment – critical aspects of the epidemic that are sorely lacking across the nation.
A recent report by the Centers for Disease Control and Prevention revealed that more than 52,000 overdose deaths occurred in 2015 in the U.S. –more than any other year on record. The majority of those deaths were related to heroin, fentanyl, and prescription opioids. In Pennsylvania alone, nearly 3,400 persons died in 2015 from an overdose, and those same drugs were associated in 81% of the cases.
~ G. Nathalee Serrels, M.A., Psychology