Despite declines,Alabama still leads in Medicare opioid prescriptions

By Amy Yurkanin

Prescription medication EJA

Alabama reports the highest rate of opioid prescriptions among people in the United States who use the Medicare drug program, according to a new report from the U.S. Department of Health and Human Services Office of the Inspector General.

Analysts with the OIG have been tracking opioid prescriptions under Medicare Part D since 2016. That research has taken on greater urgency as overdose rates reach all-time highs, causing more than 107,000 deaths nationally last year, according to the U.S. Centers for Disease Control and Prevention.

Alabama has had the highest percentage of beneficiaries who receive opioid prescriptions since tracking began, according to the experts who worked on the report. In 2021, 36% of Alabama recipients received an opioid prescription compared to the national average of 23%.

The number of beneficiaries nationwide who received an opioid prescription has dropped by more than 60% since 2016, from 501,008 in 2016 to 199,159. The number of Medicare patients receiving high doses of opioids has also dropped sharply.

Yet in 2021, more than 50,400 Medicare beneficiaries suffered an opioid overdose from prescription or illicit drugs.

“Our reports have shown that there has been progress in reducing opioid prescriptions,” said Miriam Anderson, the subject matter expert for opioids. “At the same time, we see that access to treatment is a concern.”

Beginning last year, the office also began tracking whether beneficiaries diagnosed with opioid use disorder received medication to treat the condition or prevent overdoses. More than one million Medicare beneficiaries have been diagnosed with addiction, but fewer than 20 percent receive medication to treat it, according to the report.

Researchers found that Alabama had few providers with the ability to prescribe buprenorphine, a treatment for opioid addiction.

“Alabama was among the states with the lowest number of providers with buprenorphine waivers,” said Jason Kwong, a social science research analyst with the OIG.

Doctors with buprenorphine waivers can prescribe addiction medication from a regular medical clinic. Patients also have the option of using methadone dispensed at specially licensed opioid treatment programs.

Anderson said Medicare beneficiaries aged 65 and older were three times less likely to receive medication for opioid use disorder than younger patients, who often qualify for the program due to disability. Women were also less likely than men to receive addiction-treating medication, the report found.

Researchers found that the number of beneficiaries receiving naloxone, also known by the brand name Narcan, has surged in recent years. It can reverse opioid overdoses if used quickly and has proved to be a lifesaving medication.