A report from the federal oversight agency shows that over 4,000 patients in the Ohio Valley received high amounts of opioids in 2021 through Medicaid, potentially putting hundreds vulnerable to addiction and overdose.
The Office of Inspector General for that Department of Health insurance and Human Services focused the report on six Appalachian states meant for their partnership with police force agencies who are within the Appalachian Regional Prescription Opioid Strike Force.
The IG's Office found through claims data from Kentucky, Ohio, and West Virginia that just about 400 Medicaid patients in the Ohio Valley who received high levels of opioids are at serious chance of opioid misuse or overdose.
Patients are considered at serious risk if they've received an extreme amount of opioids, which is defined as 32 tablets or even more of 5 milligram Percocet every single day for a year.
Patients who seem to be doctor shopping, or receiving high levels of opioids from multiple prescribers and pharmacies, will also be considered at serious risk.
The report found five prescribers in Kentucky and 13 in Ohio have questionable prescribing patterns.
“Even legitimate use of prescription opioids might cause harm which explains why it's so important that people only get prescription opioids when absolutely necessary and if they do have them that they're at the lowest dose for the shortest time period possible that is consistent with good health care,” Hilary Slover said.
Slover served as a team leader for that study.
This may be the first time the IG's office has been doing an analysis on the Appalachian region.
“We have done this before in Ohio and in Ohio we saw a decline within the quantity of beneficiaries at serious risk and the quantity of providers with questionable prescribing practices since May 2021,” Slover said.
The oversight agency is concerned with the potential impacts COVID-19 maybe wearing treatment and opioid prescribing, based on Slover.
“During this time some Medicaid programs have relaxed rules and suspended safeguards like the requirement of face to face visits with prescribers to get opioid prescriptions. Additionally, patients may be experiencing reduced use of in person treatment and recovery support,” Slover said.
The agency is encouraging states to expand enforcement of prescription drug monitoring programs and sharing that data with Medicaid agencies. The IG's office also suggested that data ought to be analyzed to recognize patients who may be in danger.
COVID-19 could have a greater effect on patients by having an opioid use disorder because the virus attacks the lungs. According to the report, respiratory disease is known to increase the chance of fatal overdose.
The IG's Office will release reviews that will assess the trends and challenges of opioid prescribing throughout the COVID-19 pandemic at a later date.
