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Study: 4 in 10 Medicaid patients with opiate drug prescription may misuse it

Posted at 4:00 PM, Mar 20, 2015
and last updated 2015-03-22 17:59:20-04

Nearly half of Medicaid patients with an opiate painkiller prescription may be misusing it, says a new Centers for Disease Control and Prevention study. Opiate drugs include morphine, Vicodin and Oxycontin.

Compared to people with private insurance, Medicaid patients were found more likely to use stronger painkillers and have more prescriptions. That puts an already vulnerable group at risk of abuse, overdose and death.

About 16,000 people died from opiate drug overdose in 2013. Most deaths were unintentional, according to the CDC. Almost half of prescription drug overdose deaths are people on Medicaid, which provides health coverage mostly to the poor.

“Some fraction of it is probably due to misuse of one kind or another,” said Leonard Paulozzi, a CDC medical epidemiologist and author on the study. “It re-emphasizes getting the best possible management of pain, mental health and other problems.”

Medicaid patients with an opiate drug prescription had about six prescriptions on average in 2010.

Prescription opiate use is on the rise nationwide, with sales quadrupling since 1999. Today, about 7 percent of adults over 20 have used an opiate prescription drug, according to the CDC.

Misuse among Medicaid patients may be due to poverty or how their healthcare is delivered — a large number of patients being cared for by a small number of providers, Paulozzi said.

For the study, researchers examined medical records of more than 350,000 Medicaid patients with a prescription for opiate painkillers in 2010. Misuse was determined if there were overlaps between prescriptions, high daily doses or long acting formulas for acute pain.

The most commonly prescribed opiate drugs are codeine, Demerol, morphine, Vicodin and Oxycontin. Heroin, an illegal opiate drug in the U.S., has also seen a resurgence in use.

The study was published in the Journal of Health Care for the Poor and Underserved.

Gavin Stern is a national digital producer for the Scripps National Desk.