Less Funding vs Addiction, but More Drugs

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The Courier-Journal (Louisville, KY) and Charleston (WV) Gazette each rolled out a major series on prescription drug abuse over the past two weeks, reporting how addiction to pain pills has become epidemic, with darker consequences on personal health, family stability, and even community solvency in some rural areas.

Alison Knezevich’s stories for the Gazette also look at the increasing use of Suboxone (buprenorphine) to wean addicts off of opiates like OxyContin.

The drug was federally approved for use in 2002. “In 2008, Prestera — the state’s largest mental health provider — and three other providers got a $360,000 grant from the Robert Wood Johnson Foundation to increase access to Suboxone.”

It’s considered safer than methadone and simpler to administer; patients aren’t required to take their daily doses at clinics but can pick up the pills at a pharmacy.

“Today, 17 treatment programs and more than 90 private physicians in West Virginia offer the drug,” writes Knezevich. Usually, it’s prescribed as part of a larger drug treatment regimen that includes one-on-one and group therapy, 12-step meetings, and ongoing counseling, too.

The Gazette’s stories did not say how effective the Suboxone-plus-treatment approach had been in helping addicts get clean and stay clean; perhaps it’s too early to know.

But as Dr. James Becker, medical director for the state’s Medicaid program, told the Gazette, Suboxone “took off like a rocket between 2007 and 2009,” once federal law made it easier to get.

Knezevich writes, “In 2006, West Virginia Medicaid paid about $360,000 for Suboxone claims. Last year, it was more than $4.7 million.”

She notes that “a few years ago” (presumably when access to the drug was made easier) state Medicaid officials found that Suboxone dosages were being “routinely” exceeded by 50%.  “People were diverting the drug,” Knezevich writes. According of Becker, “officials also discovered that some Medicaid patients were traveling out of state to get high doses of Suboxone — paid for by West Virginia Medicaid. They were likely taking a few per day, and then selling the others.”

In other words, this drug, too, was being abused. Medicaid has since tightened its controls on Suboxone.

Further, Knezevich writes, “In 2009, 39 West Virginia children ages 5 and younger were poisoned by buprenorphine,” (Suboxone), according to the state’s poison control center. “That was up from one child poisoning in 2005.”

Not surprisingly, Dr. Becker, the state’s chief Medicaid officer, concludes,  “Medication’s not the ultimate answer.”


Courier-Journal
Prescription drug deaths are
on the rise in Kentucky and elsewhere; meanwhile, most of the programs
that address addiction are being cut back.

The Courier’s stories focus on the disparity between rising incidence of prescription drug abuse and declining resources to deal with the problem.

“The Office of Drug Control Policy, a state agency that coordinates much of Kentucky’s fight against drugs, saw its state funding drop from $8.6 million in 2008 to $6.5 million in 2010, forcing its staff to shrink from 10 to four employees.

“Kentucky’s family and juvenile drug courts — created to help new addicts stay out of prison and mend their families — were eliminated as of Jan. 1 to save the state budget $1.5 million a year.”

 

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