Doctors should not be penalized for prescribing opioid alternatives
The terrible pain caused by the opioid crisis has reached every community in our state â€“ and our country.
So many of us have heard from Oregonians whose loved ones died from an opioid overdose after struggling with addiction—all because they filled an opioid prescription. And our nation's overdose death rate soared to record highs during the coronavirus public health emergency.
Preliminary data released by the Centers for Disease Control in August show that fatal drug overdose in 2020 rose nearly 30 percent, to a record-setting 93,331 deaths. Opioids, including prescription pain medication, caused a staggering three-quarters of those deaths—a record 69,710 lives lost. Sadly, Oregon has been hit hard with a nearly 44 percent increase in overdose deaths over the past two years.
Putting a stop to this opioid crisis requires a multifaceted response with economic and social dimensions. It also requires us to look at the underlying policy and commercial factors that drove the epidemic to reach such staggering heights of tragedy and despair.
Health care providers have taken steps to try to reduce the contribution of prescription drugs to the opioid epidemic.
According to the American Medical Association, physicians and other health care professionals' use of state Prescription Drug Monitoring Programs increased 64.4 percent and opioid prescriptions decreased by 37.1 percent from 2014 to 2019. Yet, opioid overdoses continue to be a problem, largely driven by illicit forms of opioids. Health care providers need access to a variety of options to manage their patients' pain, but often administrative and financial barriers get in the way of comprehensive, multidisciplinary pain care and rehabilitation programs.
In order to increase access to safe and effective non-opioids across America's health care landscape, we are pushing for passage of the bipartisan Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act. This legislation would address the barriers within Medicare reimbursement policies that discourage providers from offering non-opioid pain management alternatives to patients undergoing surgery.
Under the current system, Medicare does not allow adequate reimbursement for alternatives to opioids. Instead, the program shoehorns almost all non-opioid pain management treatments — drugs, devices, and biologics — used in outpatient surgery into payment "packages" that don't allow for separate reimbursement for individual treatments. As a result, providers can either take the financial hit of prescribing the alternative pain management treatments or be fully reimbursed when they prescribe opioids—even if alternatives would be more appropriate for the patient.
That's why it is critical to pass the NOPAIN Act.
By directing Medicare to allocate separate reimbursement for FDA-approved pain management alternatives, we can ensure patients undergoing a surgical procedure have a choice when deciding which treatment is best for them.
Importantly, this legislation would not prohibit or stifle patient access to physician-prescribed opioids for chronic or acute pain in any way. Instead, the NOPAIN Act would create an equal playing field that gives doctors and their patients more autonomy when choosing between differing opioid or non-opioid treatments.
With so much pain and hardship wrought by the opioid epidemic, Congress must spearhead innovative policy remedies that help address the structural causes of the crisis. The NOPAIN Act is one such remedy. By fixing Medicare's reimbursement policy to ensure patients across the country have a choice between differing pain management treatments, we can help combat one of the major drivers of this addiction epidemic.
U.S. Sen. Jeff Merkley, D-Oregon, is a cosponsor of the NOPAIN Act. Dr. David Russo is a physiatrist and pain management specialist at Columbia Pain Management, PC, in Hood River and a member of the Oregon Medical Association.
Lines for Life and the Oregon Health Authority have launched the Safe + Strong Helpline at 1-800-923-4357 (800-923-HELP). The line offers free, 24/7 emotional support and resource referral to anyone who needs it — including those struggling with drug and alcohol issues.
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