Opioid use by S.C. Medicaid recipients is down due to drug monitoring program, report says
The state’s prescription drug monitoring program is showing promising results in reducing opioid prescriptions written in South Carolina, according to a new University of South Carolina report.
USC researchers were contracted by the Department of Health and Human Services to analyze the effect of the state’s prescription drug monitoring program on Medicaid recipients’ opioid use.
Because of these patients’ low-income status, the Medicaid population is at a higher risk for opioid overdose. An epidemic of such overdoses has swept the country in recent years, and President Donald Trump recently declared opioid abuse a national emergency.
In response to the epidemic, state health leaders set up a prescription monitoring program and made it mandatory for all doctors to check before prescribing opioids. The database is run through the Department of Health and Environmental Control.
USC’s work focused on the Medicaid population, but lead researcher Ana Lopez-De Fede said the trends extend beyond those patients.
“The main take-away is that the policy change has made a difference in the number of prescriptions for this population,” Lopez-De Fede said. “They’re avoidable and unnecessary. It also indicates we have more work to do.”
There was a 29 percent drop in the number of opioid prescriptions since the monitor was put in place, the study found. Researchers also found that dangerous doses being given dropped somewhat.
Heroin use often begins with a prescription painkiller. Heroin, fentanyl and prescription painkillers like Oxycontin give relief to the body’s pain receptors in different ways, though street drugs are much more powerful and harder to quit. High rates of prescribing opioid painkillers creates a risk of a broader heroin problem, as seen in states like Ohio, Maryland and West Virginia.
South Carolina doctors write more opioid prescriptions every year than there are residents in the state, according to the Centers for Disease Control and Prevention. Lopez-De Fede said prescriptions of opioids for 90 days or more are especially risky, because research shows those high doses often lead to addiction.
Legislators in South Carolina sought to curb prescriptions for the potent drugs by putting a monitoring program in place. It was rolled out in 2013 and became mandatory for all doctors to use for Medicaid patients in April 2014. It became mandatory for every patient earlier this year.
The report found opioid users were much less likely to overdose on heroin after their doctors began using the prescription monitoring program.
Bryan Amick, deputy director of health programs for the Department of Health and Human Services, cautioned against assuming the prescription monitoring program is a catch-all solution. Rates of overdose deaths in South Carolina have gone up in recent years, even as the monitoring program was rolled out.
“No single lever or policy intervention is going to solve the problem,” Amick said.
Christie Frick, director of DHEC’s monitoring program, said several hundred practitioners have signed up since the program became mandatory. She said it’s difficult to say how many more doctors still should sign up.
She said she knows the program is still difficult for some providers. The Greenville Health System recently began using new software to help its providers integrate the monitoring system into their existing system. Other hospitals have made similar moves to ease the transition for their doctors.
Frick said complaints are rare. She stressed the program is not meant to keep prescriptions from people who need them but to empower doctors with more information to keep opioid prescriptions out of the hands of people who might abuse them.
“It’s given prescribers better confidence in knowing what their patients are taking,” Frick said. “They don’t have to be concerned about overdosing the patient if they can see they’re getting medications elsewhere.”