Medicare compounds the (Opiate) epidemic by funding needed opioids that can be abused

The face of the nation’s opioid epidemic increasingly is gray and wrinkled.

But that face often is overlooked in a crisis that frequently focuses on the young.

Consider this: While opioid abuse declined in younger groups between 2002 and 2014, even sharply among those 18 to 25 years old, the epidemic almost doubled among Americans over age 50, according to the Substance Abuse and Mental Health Services Administration.

Because of information like that, the Senate Special Committee on Aging convened a hearing Wednesday on opioid misuse by the elderly.

“Older Americans are among those unseen in this epidemic,” said Sen. Robert P. Casey Jr. (Pa.), the top Democrat on the panel. “In 2016, one in three people with a Medicare prescription drug plan received an opioid prescription. This puts baby boomers and our oldest generation at great risk.”

Unwittingly, Medicare compounds the epidemic by funding needed opioids that can be abused, but, generally, not funding the care and medicines needed to fight opioid addiction.

“Overall, one in three older Americans with Medicare drug coverage are prescribed opioid painkillers. However, while Medicare pays for opioid painkillers, Medicare does not pay for drug and alcohol treatment in most instances, nor does it pay for all of the medications that are used to help people in the treatment and recovery process,” William B. Stauffer, executive director of the Pennsylvania Recovery Organizations Alliance, in Harrisburg, Pa., said at the hearing. “Methadone, specifically, is a medication that is not covered by Medicare to treat opioid use conditions.”

Offering scary statistics and practices involving older folks, Gary Cantrell, a deputy inspector general at the Department of Health and Human Services, said “our nation is in the midst of an unprecedented opioid epidemic.”

He focused on Medicare Part D beneficiaries. Part D is the prescription drug section of Medicare, the government health insurance program covering older people. About a half-million Part D recipients “received high amounts of opioids” in 2016, Cantrell said. Almost 20 percent of that group are at “serious risk of opioid misuse or overdose,” he warned, placing the high risk in two categories — those receiving “extreme amounts of opioids” and some “who appeared to be ‘doctor shopping.’ ”

Doctor shoppers “each received high amounts of opioids and had four or more prescribers and four or more pharmacies for opioids,” Cantrell explained. “While some of these beneficiaries may not have been doctor shopping, receiving opioids from multiple prescribers and multiple pharmacies may still pose dangers from lack of coordinated care. Typically, beneficiaries who receive opioids have just one prescriber and one pharmacy.”

Many elderly get hooked on opiates through prescriptions, rather than street drugs like heroin.

“Older adults are at high risk for medication misuse due to conditions like pain, sleep disorders/insomnia, and anxiety that commonly occur in this population,” said Stauffer, who is in long-term recovery. “They are more likely to receive prescriptions for psychoactive medications with misuse potential, such as opioid analgesics for pain and central nervous system depressants like benzodiazepines for sleep disorders and anxiety. One study found that up to 11 percent of women older than age 60 misuse prescription medications. The combination of alcohol and medication misuse has been estimated to affect up to 19 percent of older Americans.”

Sixty-one-year-old Denise Holden is in long-term recovery, too, but she became addicted as a young woman seeking a heroin high. She’s been in recovery for almost 25 years, after first using drugs when she was 19. She got clean, then relapsed, as is common, then got clean again. Staying that way, even after decades clean, is not easy.

“I recently had back surgery,” the West Melbourne, Fla., resident said in an interview. “I had a spinal fusion and so I had been taking opiates for a period of time. You know, the older we get the more aches and pains we get. … We injure ourselves, we have surgeries. So, for people in recovery it’s a slippery slope because when you reintroduce that opiate to your system, your mind starts playing all kinds of tricks on you — ‘Oh you should take more, oh you should take less, oh you should throw them out. Oh no, take them all at once.’ It’s very difficult, like it’s a mind game. It is very challenging I would say, but it’s not impossible.”

Holden urged seniors to take medicines only as prescribed, and if they have suffered drug abuse to “work a very strong program of recovery.”

Addiction isn’t the only risk with opioids. Sen. Susan Collins (R-Maine), chairwoman of the committee, said, “Older adults taking opioids are also four to five times more likely to fall than those taking nonsteroidal, anti-inflammatory drugs.”

That points to a vicious cycle. Taking opioids can lead to falls, falls can lead to pain, pain can lead to opioids and opioids can be abused. On top of that, doctors might not even realize the source of an elderly patient’s problem.

“Regrettably,” Collins added, “health-care providers sometimes miss substance abuse among older adults, as the symptoms can be similar to depression or dementia.”

6 Responses

  1. This article mentioned “doctor shopping” and using up to 4 differing drugstoress to obtain the scripts.Well,WHAT???where is this magical place?pain mngmt.patients have been on Uncle”Babylon”Sam’s spy lists for years now!I didnt get it.If there was a doc.and pharmacy on Pluto,they would know about it.Multiple docs.and drug stores are a thing of the past going on 15yrs.or more now.If you fart,they’ll put you on their invasion of privacy list.And Donna Ratliff,thankfully my mom has gone to glory as well.Her Dr.BRIAN MAGRANE[migraine]in Islamorada,Fla.Keys,gave her fentanyl patches,low dose,but one day suddenly denied her the ‘breakthru’med she needed.Her left foot was horrifically mangled and reassembled with the orthopaedic skill of a 3yr.old.She was not abusing,selling,or any of that rot.Thank God she passed in a hospitalthat saw fit to ease her final pain[foot had gone cancerous]I deeply hope this damages that pricks practice.He got a lengthy letter from us in regards to his treatment of her.And a large portion of it cannot be repeated here for decency sake.Rather than file on him for malpractice,I decided the internet exposure gouges him in the short n curlies.Decent medical help is non existent in the Keys!

  2. Yellow journelism, alive and well at the WaPo. Giving everybody a big heads up on the coming increase in government sponsered and directed Elder Abuse. I mean gee imagine this the elderly are having their multiple, chronic conditions treated appropriately with legal, FDA approved medications and many have been for possibly decades and yet now all of a sudden they need the moral, nanny’ state entrepreneurs to protect them. I get so livid anymore upon reading this agenda driven garbage if the person who is responsible was in front of me They would look and feel very different shortly thereafter!! And yes I am in excruciating nonestop, non relieved pain as I write this.

  3. The only Abuse I Know is Going On is the Abuse and Torture of pain patients. There Transhumanist Agenda being to Stress-Out, Experiment, Exploit, and ultimately Kill us. KEEP IN MIND,. ALL THIS PROPAGANDA ONLY ONLY APPLIES TO The COMMONS

  4. With Donna Ratliff, completely…until reading this, I wasn’t aware I was considered elderly. That was a nice respectful touch. If this is not a tell or hint as to where this entire fake opiate crisis is headed. Looking at the point that my sister has tried to convince me of. She is certain what’s it’s a version of the purge movies. The less productive older citizens. Her perception is painfully not far from that mark, seemingly moving more closely in that direction. Being in pain is hard as we know, but on top of that. We’re talked about like we’re just taking up space like we’re not even in the room any longer. Yes we may be older and yes we do have a lifetime of experiences (once called ‘wisdom’). We have some aches and pains some more than others. Yet, we are grateful, as most of us by now have experienced loss on a larger scale. I’m proud of my scars; the roadmap of my battles for precious life, and I’m still here fighting.
    I propose all representatives Congress HHS, CDC and NIH, DEA
    all the well-paid agencies must go for a drug test every 1- 3 months like we do, jump through the hoops! If your child, your spouse or you have an accident or illness that requires medication- yet your pharmacy is out and won’t get more until next week, & your required to only use that one pharmacy or risk your job, accusations of diversion or addiction…just remember it’s for your own good and you “will be so much better once your CLEAN”, etc. I truly wish you the best, if you are lucky enough to get to say 15 years before retirement age unscathed, you remember all those not as fortunate.
    We are trying to make life count, even when it’s a wicked rough road. We didn’t ask for this, no one does! As I stated previously, I truly wish you all the best. Just know God see’s all, and all will be held to account. If your into camp Karma, well she is a bigger B than myself & most all of us could ever be.
    It is insanity to think we have the desire (in droves) to go to multiple doctors to shop for multiple prescriptions from multiple pharmacies it’s ludicrous. AG Sessions, I do believe for those in agreement with this article has now reached his useless age, commonly know as a “Best before/expiration date”. How do you even try to make sense of something which is so clearly age discriminatory practices. I see ‘NIMBY’ is still being practiced, now on steroids. Still calling the ACL you please pick up! Government has decided to take up a new hobby over the past few years now they formed league it is the kick the disabled kid on the playground sport play dodgeball with grandma being the target. News to me that there so many older individuals clamoring to go out and get high… imbecilic. What an insult while we’re at it can we stop cigarettes/tobacco which kills so many more people. Also, no more alcohol…yes let’s do away with that too! Oh damn, I forgot. No can do; you get a huge tax revenue from both of those. Regardless of the fact that they actually do kill thousands and thousands more people. Also most kids start with a cigerette and or alcohol, before prescription & illicit drugs!
    Mad as hell…not going to take it, politely, anymore! Ironically on memorial day or not. I don’t think many of these ‘apathetic, unappreciative individuals’ even know anything about Memorial Day or respect. It’s a day off work… to take the boat to the lake, grill out and have a few cold ones.
    Sorry for the length…I’m really angry & hurt!

  5. Oh this article pissed me off! You betcha I went to it and left a comment. I used all 2000 characters too. I hope everyone especially seniors went there and have those Senators a piece of your mind!
    Now,.. I want to find those senators that said all that crap and tell them as well. Seniors and elders have paid the MOST into Medicare and they deserve to have pain relief from their back breaking jobs we did all lives, 40 yrs or more. Paid taxes too. It’s not our fault that Congress squandered all the medicare money. I’ll bet that’s what a lot of this is really about.
    So anyway,.. I hope that all reading this blog go over and comment. And find all senators who are saying all thus BS and give them Hell. The Stress of all this keeps my hard to control bp high and my.anxiety goes off the charts at every dr appointment. We seniors should not be having to worry about our Quality of Life medications.
    If loss of meds doesnt end up killing me? The stress surely isn’t helping my health. I’ve now got new pain conditions to add on top of what I already had. Lord have mercy, Save us all.
    This is beyond unbelievable. Thank God my mother isn’t still alive.
    Keep fighting folks! Never give up!

    • Donna Ratliff, They are (at least several of them quoted were) from Pennsylvania, an ass-backward state (Commonwealth) that I unfortunately have to call “home” for now. You wouldn’t imagine the things they call laws here…PLEASE write to them!!!!

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