It’s High Time for Broader Access to Non-Opioid Pain Medication


Overdose deaths in the US have reached an all-time high: over 107,000 in a single year. This crisis was mainly caused by opioid overdose-related deaths. Given that the total number of drug overdose deaths in the US has surpassed 1 million since 1999, it is clear that 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’ve lost to addiction and share solutions to prevent overdose deaths and save lives. As part of this important effort, it is critical to pass legislation to 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 began after being exposed to opioids after a simple surgical procedure. In 2012, more than 255 million opioid prescriptions were issued in the United States – almost enough for every American adult to have their own personal opioid prescription. Although the healthcare system has made strides in reducing unnecessary prescriptions – 142 million opioid prescriptions were issued in 2020 – it remains far too difficult for healthcare professionals and patients to choose non-opioids for pain relief.

Opioid-based medications are an important option for certain patients, including those who struggle with excruciating pain on a daily basis. But our healthcare system goes further by encouraging the use of these powerful treatments for acute pain. This has contributed to the quadrupling of deaths from prescription opioids in the US over the past 15 years.

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Many Americans who become dependent on or abuse opioids are first exposed to drugs during or after surgery. According to a study on prescriptions after orthopedic surgery, the average patient was prescribed 80 opioid-based pills — and half of those pills sit unused in medicine cabinets, waiting to be abused.

Medicare, which insures over 62 million beneficiaries, has contributed to this crisis. Medicare’s legacy reimbursement system does not provide adequate reimbursement for non-opioid alternatives for treating post-surgical pain, meaning many facilities are forced to pay for non-opioid drugs, devices, and pain management therapies, or simply do not make these options available to patients and healthcare providers. Unfortunately, this is an increasingly unsustainable burden as facilities report rapidly declining operating margins and are forced to simply limit access to these therapies.

While people, including many healthcare professionals, often view opioid addiction as a problem that primarily affects younger Americans, about 3% of Medicare beneficiaries — or nearly 2 million older Americans — live with an opioid use disorder — and many more leave bottles of it potentially addictive making painkillers lying around in their medicine cabinets for family members to access. A recent report by the Office of the Inspector General found that more than 50,000 Part D beneficiaries suffered an opioid overdose in 2021.

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Non-opioid alternatives, on the other hand, can help patients manage pain while reducing the risk of patients developing opioid use disorder. This approach to pain management can save lives.

I am confident that our country will soon overcome this epidemic. To do this, we must prevent addiction where possible, whether in the general population or in specific groups such as older Americans.

We can do this with the help of a bipartisan bill that is quickly gaining ground in Congress. If enacted, the Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act (S. 586/HR 3259) would help ensure every Medicare beneficiary has access to safe, effective non-opioid drugs and devices . By removing barriers to opioid alternatives in ambulatory surgery centers and hospital outpatient departments, the widely supported legislation would empower more patients and their healthcare providers to choose non-addictive pain management approaches. Importantly, legislation does not prevent or minimize access to prescription opioids when clinically appropriate; it simply levels the playing field and creates more choices for patients and medical providers.

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Healthcare providers and patients should have a say in what treatment options work best for them — not just Medicare’s payment policies. With over 43 opioid prescriptions per 100 Americans in 2020, it’s clear this broken system is only making the opioid epidemic worse.

This bill has already received the support of over 110 members of the House of Representatives 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. Thank you to all of these champions for joining the fight against addiction and overdose. I urge every legislator on Capitol Hill and every health organization to join the growing number supporting this vitally important legislation.

As healthcare providers and patients have more choices in directing their treatment plans, we could be one step closer to ending the opioid epidemic out of control.

Chris Fox is Managing Director of Voices for Non-Opioid Choices.



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