0
Viewpoint |

Responses of State Medicaid Programs to Buprenorphine Diversion:  Doing More Harm Than Good?

Robin E. Clark, PhD1,2,3; Jeffrey D. Baxter, MD1,2
[+] Author Affiliations
1Department of Family Medicine and Community Health, University of Massachusetts Medical School, Shrewsbury
2Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury
3Department of Quantitative Health Sciences, University of Massachusetts Medical School, Shrewsbury
JAMA Intern Med. 2013;173(17):1571-1572. doi:10.1001/jamainternmed.2013.9059.
Text Size: A A A
Published online

Extract

Abuse of prescription opioids is an increasing national concern. Recent reports point to growing rates of overdose, addiction, emergency department visits, and death attributable to nonmedical use of prescription pain medications.1,2

Opioid misuse and addiction has an especially important impact on Medicaid programs; rates of drug abuse among covered individuals exceed those of other insured populations.3 Opioid agonist treatment with methadone hydrochloride or buprenorphine hydrochloride is the most effective way to treat opioid addiction.4 Medicaid programs in most states cover methadone treatment and in all states cover buprenorphine, but there is concern that either medication can be abused. As a consequence, daily on-site dosing is required for most patients who are prescribed methadone. Buprenorphine carries a lower risk of sedation and overdose; it can more safely be dispensed for unsupervised use at home. Prescriptions for the leading sublingual buprenorphine hydrochloride–naloxone hydrochloride product (Suboxone; Reckitt-Benckiser) have risen sharply since 2002, when the US Food and Drug Administration (FDA) approved its use for treatment of opioid addiction. At present, more than 20 000 physicians are certified to prescribe buprenorphine. Patients filled an estimated 9 million prescriptions for buprenorphine in 2012. For a typical patient, the medication costs about $325 a month.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
Jobs
brightcove.createExperiences();