Prescription drug abuse – are you complicit?

Joe Paduda

First published 4/20/11 on Managed Care Matters

This morning’s NYTimes has a heart-crushing story about a town in Ohio devastated by abuse of OxyContin and other prescription narcotics.

Here’s what prescription drug abuse has done to Ohio.

- in 2007, deaths from prescription drug abuse (PDA) in Ohio surpassed deaths from motor vehicle accidents.

- more people died from PDA in Ohio in two years than died in the World Trade Center in 2001.

- almost one in ten babies born in Scioto County tested positive for prescription drugs.

Around the nation, the numbers are equally terrifying.

- Prescriptions for opiates (hydrocodone and oxycodone products) went from 40 million in 1991 to nearly 180 million in 2007

- The U.S. consumes 99 percent of the world total for hydrocodone (e.g., Vicodin) and 71 percent of oxycodone (e.g., OxyContin).

PDA grew by 400% from 1998 to 2008. Four hundred percent.

And those are just the statistics.

There’s no figure, no number or percentage, that can describe the pain felt by parents, spouses, siblings who lost someone to PDA.

These abusers are getting the drugs from somewhere, and some portion of the drugs that are killing these people are paid for by insurers. At some point, some enterprising attorney is going to ask the question; “What did you know about this person’s drug profile, when did you know it, and what action did you take?”

Play that conversation thru in your mind.

Which leads to the question, what are we going to do about it?

And more precisely, what are YOU going to do about it?

If you work for an insurer or TPA, are you monitoring potential PDA? Looking for possible abuse or diversion? Tracking provider prescribing patterns? Identifying claimants at risk for doctor shopping or use of multiple pharmacies?

Or are you thinking about it, debating, discussing, having meetings and writing memos? Getting ready to get ready?

Not only is there a societal cost of PDA, there’s also a fiduciary obligation. Payers have the technology, data, and analytical abilities to identify potential PDA. It’s time to stop ignoring the problem, get off our collective butts, and take action.

Joe Paduda is an analyst and consultant to the group health and workers’ compensation sectors. He writes at Managed Care Matters.

This entry was posted in Market Dynamics, Medical Management, Quality and tagged , , . Bookmark the permalink.

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