Overdose deaths have hit an all-time high in the U.S.: over 107,000 in a single year. This crisis has been driven predominantly by opioid-related overdose deaths. With the total number of drug overdose deaths in the U.S. surpassing 1 million since 1999, it’s clear the problem shows no signs of abating.
September is National Recovery Month, a time to celebrate the 22 million Americans in recovery, remember those we have lost to the disease of addiction, and share solutions to prevent overdose deaths and save lives. As part of this important effort, it is critical to pass legislation to help prevent addiction before it begins by expanding access to and use of non-addictive pain management treatments.
How did we get here? For some, it started after being exposed to opioids following a simple surgical procedure. In 2012, there were more than 255 million prescriptions for opioids dispensed in the U.S. — nearly enough for every American adult to have their own personal opioid prescription. Though the healthcare system has made progress in reducing unnecessary prescriptions — as there were 142 million opioid prescriptions dispensed in 2020 — it remains far too difficult for healthcare professionals and patients to choose non-opioids to help manage pain.
Opioid-based drugs are an important option for certain patients, including those dealing with daily excruciating pain. But our healthcare system goes further by encouraging the use of these powerful treatments for acute pain. This has contributed to prescription opioid deaths in the U.S. having quadrupled in the past 15 years.
Many Americans who become addicted to or abuse opioids are first exposed to the drugs during or after surgery. According to one study on prescribing following orthopedic surgery, the average patient was prescribed 80 opioid-based pills — and half of these pills remain sitting unused in medicine cabinets waiting to be misused.
Medicare, which provides insurance for over 62 million beneficiaries, has contributed to this crisis. Medicare’s outdated reimbursement system does not provide adequate reimbursement for non-opioid alternatives used to manage postsurgical pain, meaning that many facilities must cover the cost for non-opioid drugs, devices, and pain management therapies or simply not make these options available to patients and healthcare providers. Unfortunately, this is an increasingly untenable burden as facilities report rapidly declining operating margins, and are forced to simply restrict access to these therapies.
While people, including many healthcare professionals, often think of opioid addiction as an issue mainly affecting younger Americans, approximately 3% of Medicare beneficiaries — or nearly 2 million elderly Americans — live with opioid use disorder — and many more leave bottles of potentially addictive painkillers laying around in their medicine cabinets for family members to access. A recent Office of the Inspector General report found that more than 50,000 Part D beneficiaries overdosed on opioids in 2021.
Non-opioid alternatives, on the other hand, can help patients manage pain while reducing the risk of patients developing an opioid use disorder. This approach to pain management can save lives.
I am hopeful that our country will soon turn the corner on this epidemic. To do so, we need to prevent addiction whenever possible – whether among the broader population or specific groups like older Americans.
We can do this with the help of a bipartisan bill that is quickly gaining ground in Congress. If signed into law, the Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act (S. 586/H.R. 3259) would help ensure that every Medicare beneficiary has access to safe, effective non-opioid drugs and devices. By removing barriers to opioid alternatives in ambulatory surgical centers and hospital outpatient department settings, the widely supported legislation would empower more patients and their healthcare providers to choose non-addictive pain management approaches. Importantly, the legislation does not prevent or minimize access to prescription opioids when it is clinically appropriate; it simply levels the playing field, creating more choice for patients and medical providers.
Healthcare providers and patients should have a say over which treatment options are best for them — not Medicare payment policy alone. With over 43 opioid prescriptions written for every 100 Americans in 2020, it’s clear this broken system is only worsening the opioid epidemic.
This bill has already gained the support of over 110 members in the House and half of the Senate. It has also been endorsed by various medical organizations, including the American Medical Association and the American Society of Anesthesiologists. I thank all these champions for joining the fight against addiction and overdose. I urge every lawmaker on Capitol Hill and every healthcare organization to join the growing numbers supporting this critically important legislation.
With healthcare providers and patients having more choice in the direction of their treatment plans, we could be one step closer to reigning in the out-of-control opioid epidemic.
Chris Fox is executive director for Voices for Non-Opioid Choices.