Heightened painkiller-abuse attention snares provider interest

Heightened calls to curb painkiller-related hospitalizations and deaths on both sides of the aisle in Congress and the presidential campaign trail may make providers concerned about more restrictions on medications in long-term care.

Deaths from prescription painkillers have quadrupled since 1999. Each year more than 44,000 Americans die from drug overdoses — the bulk of which come from heroin and abuse of painkillers, according to the Centers for Disease Control and Prevention.

In February, a Congressional panel sent two bills to the House designed to curb prescription drug abuse and streamline Drug Enforcement Agency scheduling of approved controlled substances.

Both bills have big implications for long-term care providers, who have been challenged by drug diversion and other medication management issues, while also trying to preserve a vital flow of pain management medications for their seriously ill patients.

In Congress, bipartisan efforts led by Senate Majority Leader Mitch McConnell (R-KY) and Sen. Ed Markey (D-MA) are afoot to draft legislation, while enlisting Health & Human Services support from the Surgeon General and National Drug Control Policy Director Botticelli, according to a news report published Monday. Hillary Clinton has also weighed in on the subject, vowing to address the matter as part of her campaign, The Hill reported.

In addition, the White House recently launched an initiative to train doctors on better prescribing practices while expanding treatment with medication and counseling, the report adds.

The full extent of drug diversion occurring in long-term is unclear; experts say most occurs outside hospitals. Researchers noted in a July 2012 issue of Mayo Clinic Proceedings that most drug diversions occur in the outpatient setting and the most commonly diverted drugs are opioids. In any given year, about one-third of all Medicare Part D enrollees use opioids, some of which may not be clinically appropriate, according to a MedPAC analysis on inappropriate opioid use.