On February 2, 2016, the Centers for Medicare and Medicaid Services (CMS) posted a bulletin highlighting state-based strategies to combat the epidemic of opioid-related drug abuse, overdoses, addiction, avoidable hospitalizations, and deaths. Out of 43,982 drug overdose deaths in the United States in 2013, 37 percent were associated with prescribed opioid analgesics, such as methadone and oxycodone. Such deaths quadrupled from 1999 to 2011. CMS cites innovative strategies and exemplary practices that are beginning to achieve results in states such as California, New York, Florida, Ohio, North Carolina, Virginia, Washington, Oklahoma, Rhode Island and Vermont.
CMS strongly urges state Medicaid agencies to promote the use of safer pain medications through methods such as: retrospective and concurrent drug utilization review (DUR) targeting high-risk opioids, provider education, preferred drug lists (PDLs), “point-of-sale” information technology authorizing opioids to control pain only when certain clinical criteria are met, “step therapy” (i.e., requiring that safer pain medications are tried first), improving access to opioid use disorder treatment, and collaboration with other state prescription drug monitoring programs (PDMPs) usually based in other state agencies.
The CMS bulletin, entitled “Best Practices for Addressing Prescription Opioid Overdoses, Misuse and Addiction,” is available here.