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 Silent but Deadly Abuse Fuels Opioids Epidemic Among Aging Americans

As Congress and the White House this week take public action to address the opioids epidemic, a group of experts convened to discuss how the rampant problem is a big issue among America’s elderly population, with one out of every three Medicare beneficiaries receiving a prescription for an opioid drug in the year 2016.  

The Hill newspaper on Oct. 24 hosted “America’s Opioid Epidemic: Aging & Addiction,” to explore how younger people addicted to heroin or synthetic opioids are not the only population at the center of the storm. Seniors are also at risk, and possibly more so given the need for pain treatment for the over-65 population as they cope with chronic disease and are prone to longer recovery periods for fractures, falls, and other health problems.

While not dealing with how opioids are controlled and managed in skilled nursing or other forms of long term care, the discussion did tackle the need to pay special attention to how prescription drugs are dispersed to seniors, and how they could be better tracked to not only relieve possible addiction for seniors, but also for people in their lives who may steal drugs for their own dependencies.

Ann Maxwell, assistant inspector general for evaluations, Office of Inspector General, Health and Human Services Department, said the problem of overprescribing is real. “Medicare may be paying for opioids that are not medically necessary” or are being diverted for resale, she said. A July report by her office found that some 500,000 Medicare beneficiaries received high amounts of opioids and that of that number, nearly 90,000 are at “serious risk” of opioid misuse or overdose.

While there are criminal elements even among senior citizens in receiving or selling prescription drugs for profit or to feed an addiction, the nuts and bolts of the issue are that seniors may be unwittingly prone to become dependent on their pain medications because they listen to their doctors all too well, said Rep. Markwayne Mullin (R-Okla.), a co-sponsor of a bill to require electronic prescribing of opioids.

“They get prescribed maybe one of six medications,” he said, and each says to take the medication daily or four times a day. But, the opioid drug bottle may say take once every four hours or as needed, but the senior does not see the “as needed” or follows the directions for once every four hours instead.

Rep. Katherine Clark (D-Mass.), co-sponsor of the e-prescribing bill with Mullin, added that “seniors take doctor orders and will take the medicine.”  And, she said, experts know that if you are exposed to opioids, a certain percentage will become dependent on the drugs. “This is more of a quiet, more silent, but equally deadly part of the opioid epidemic,” Clark said.

E-prescribing would help stem the tide of opioid abuse via prescriptions by forcing electronic funds for payment, taking cash out of the system and allowing data to be collected on exactly what is being prescribed and how often, proponents said.

The Hill event comes during a week of activity on opioids. The House Energy and Commerce panel held a hearing on the subject on Oct. 25 where government officials declared opioids the No. 1 health issue facing the country. President Trump is scheduled to make a speech on Oct. 26 outlining new measures to curb the epidemic.

Earlier in the week, the House overwhelmingly approved legislation to increase the ability of the U.S. Customs and Border Protection to detect opioid smuggling by authorizing $9 million for chemical screening devices and availability of expert personnel to stop importation of fentanyl and other synthetic opioids.

The issue of opioids and abuse was the subject of a recent presentation before an America’s Health Insurance Plans conference, where stakeholders highlighted how Patient Review and Restriction programs are integral to tackling abuse. These programs have long been used by commercial health insurers and could be better adapted to work for Medicare and Medicaid beneficiaries and their providers, stakeholders said.

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