0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
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

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

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.
Submit a Comment

Multimedia

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

Web of Science® Times Cited: 1

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

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

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();