Why it’s so hard to break an opioid addiction
Every day, more than 130 people in the United States die from an opioid-related overdose, according to the Centers for Disease Control and Prevention. Reversing the epidemic means that patients who need treatment can access it without delay and are not handcuffed by health insurance company paperwork or prior authorization.
We need House Bill 121 passed into law because it eliminates barriers to treatment. HB 121 will save lives in Kentucky.
Last year, Kentucky had the eighth-highest opioid overdose death rate in the nation — but there also was a decrease in mortality from prescription opioids between 2016 and 2017, according to the CDC. Heroin-related mortality decreased for the second year in a row, but illicit fentanyl overdose is at an all-time high.
For years, Kentucky has been among the hardest hit in the nation. Kentucky physicians and policymakers have implemented nearly every policy imaginable, including greater use of the state Prescription Drug Monitoring Program, more judicious use of prescription opioids and greater access to naloxone to reduce death from opioid-related overdose.
Kentucky’s physicians and other health-care professionals used the state PDMP more than 5.7 million times in 2017. Opioid prescriptions have decreased by more than 23 percent since 2013. Kentucky physicians and pharmacists are doing an excellent job at helping ensure persons who are at risk of overdose have access to naloxone.
These efforts are helping, but we need to focus more intently on treating patients with an opioid use disorder.
According to the most recent data from the amfAR Opioid & Health Indicators Database, 89 percent of those needing addiction treatment in our state aren’t currently receiving it.
HB 121 removes insurance company hurdles for medication-assisted treatment (MAT), which combines evidence-based medication with mental health and social supports. MAT is called the “gold standard” by the U.S. Surgeon General.
Today, insurers in Kentucky, like many other states throughout the country, require prior authorization for MAT, which requires patients to get a sign-off from their insurance company before they can receive treatment. These unnecessary restrictions make patients wait days and sometimes even weeks for treatment, putting them at risk of overdose as they are more likely to seek drugs elsewhere to avoid painful withdrawal.
Other states, including Pennsylvania, recently took action through an agreement between the governor’s administration and the state’s seven largest insurers to eliminate prior authorization requirements. Through HB 121, we have an opportunity to not only match but go further than the Keystone state. What are we waiting for?
We have the opportunity to show the country our resolve toward ending the opioid epidemic. Only a few states have taken this step. It’s time for Kentucky to do so.
Dr. Bruce A. Scott is a Louisville ear, nose and throat specialist with Kentuckiana ENT. He currently serves as president of the Kentucky Medical Association and vice speaker of the American Medical Association House of Delegates. Dr. Patrice A. Harris is president-elect of the American Medical Association and chair of the AMA Opioid Task Force. She is a practicing psychiatrist in Atlanta.