Under New Law Maine Sees Fewer Opioid Prescriptions

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A report released this month shows doctors in Maine are writing fewer opioid painkiller prescriptions in a state that rolled out one of the nation’s toughest prescription monitoring laws.

A Maine Bureau of Insurance report of insurance carriers finds that opioid prescription claims dropped by nearly 20 percent, with about 27,700 fewer claims between the first half of 2016 and the same period in 2017.

The report also measured the drop in money spent on painkillers: Insurance carriers spent $2.4 million less on opioid and opioid derivatives, while plan members spent nearly $580,000 less.

The report is inconclusive, but says the drop in prescriptions could be due to providers weaning patients off painkillers or uses of alternative pain treatments, such as physical therapy or massage.

“There are a lot less pills on the street and hopefully by reducing the amount of prescribing, we’re also introducing opiates to less people,” Ross Hicks, a Brunswick man in long-term recovery from addiction who works with the Health Equity Alliance. “We’ve gotten past the idea that opiates are great for everything.”

The federal Centers for Disease Control and Prevention says opioid painkiller prescriptions have dropped overall nationally in recent years after surging since the late ’90s and peaking in 2010. Maine topped the nation for the rate of prescriptions for highly addictive, long-term opioid painkillers in 2012 and is now one of the few states that have capped daily opioid painkiller dosages and require electronic prescriptions.

The state’s also noted that high-dose opioid prescriptions have fallen steadily among Medicaid recipients since Maine’s law went into effect in 2016.

But some Mainers say they’re being forced off painkillers while struggling to access alternative therapies. Jeff Bacon said he’s been completely weaned off a high-dose of opioid painkillers since November. Bacon, of Hampden, Maine, said he was prescribed the drug for decades for degenerative disc disease.

“It’s been a struggle to try to get sleep or do anything, to be honest,” he said. “I’m 56 years old. I’m not a person abusing things. I’m in pain. This is ridiculous.”

Gordon Smith, executive vice president of the Maine Medical Association, said he hopes exceptions in Maine’s painkiller limits law have helped people who’ve struggled “through no fault of their own.”

Observers agree Maine’s law has its limits.

Tougher prescribing laws can help keep opioids off the streets and lower the risk of unintentional overdoses, said Maine physician Lisa Letourneau. But don’t expect such efforts alone to sharply reduce overdose deaths, she said.

“A significant proportion of the overdose deaths in Maine and nationally over the last few years has been contributed by heroin and fentanyl, and particularly heroin and opioid pills that contain fentanyl,” said Letourneau, medical director of Maine Quality Counts.

Fentanyl also is fueling overdose deaths in Maine, which saw 376 total overdose deaths in 2016, up from 272 in 2015. Full data isn’t available yet for 2017, but 185 people died of drug overdoses in the first half of 2017, compared to 193 in the same period in 2016.

Maine must address low Medicaid reimbursement for substance use disorder treatment and stop stalling efforts to expand access to naloxone, said Malory Shaughnessy, executive director for the ?Alliance for Addiction and Mental Health Services in Maine.