Chronic pain patients at risk to lose opioids due to Oregon Medicaid proposal

The Oregon Health Authority is considering a proposal for the state’s Medicaid program that will remove opioid painkillers from patients who experience chronic pain. The proposal would require these patients to ultimately eliminate their opioids over a 12-month period of time. The intention is to increase the safety of patients and find different ways of helping the pain. The OHA states that, “Oregon has one of the highest rates of prescription opioid misuse in the nation.” Due to a growing dependency on opioids, an average of 3 people in Oregon die each week from an overdose from prescription opioids.

The proposal’s restrictions state that prescriptions would be confined to a seven-day supply, with potential to resume the prescription up to 90 days, contingent on the patient showing no signs of being at high risk for abuse. If a care provider believes that the opioid taper is not the best choice for the patient’s circumstances, an exception could be made. The proposal would not pertain to rheumatoid arthritis and cancer pain. Replacement treatment options the Oregon Health Plan would cover would include acupuncture, physical therapy, and yoga.

According to Portland Business Journal, the Health Evidence Review commission was sent hundreds of emails objecting to the proposal and expressing concerns from both pain specialists and patients. Some indicated that patients may seek out illegal avenues on how to get opioids, such as street drugs and thinks that this penalizes the patients who do not abuse the opioid prescriptions. In the report conducted by the Chronic Pain Taskforce, written public testimonies from angered patients and experts say that involuntary taper from opioid therapy increases pain and risk of suicide, while reduces function and the ability to work.

On September 20th, the Health Evidence Commission’s Chronic Pain Task Force will meet in Wilsonville, Oregon to discuss the feedback they received on August 9th in regards to the proposal and to discuss the framework for the evidence evaluation. Any implementation of the proposal would be in January 2020.