Opioid Epidemic: Dependence in Seniors and the Disabled

Steven Mott by Steven Mott | Licensed since 2012
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This article was updated on: 07/25/2018

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Medicare coverage is for seniors and some people with disabilities, many who take prescription opioids to manage pain from surgery, injury, or illness. In 2016, one in three Medicare Part D beneficiaries received a prescription opioid, according the U.S. Department of Health & Human services (HHS). However, opioid use has led to an opioid epidemic in the U.S., reports HHS. The opioid crisis is responsible for the majority of overdose deaths in the U.S. today, according to the Mayo Clinic, with nearly half of opioid-related deaths involving prescription opioids according to HHS.  In 2016, around 66% of the 63,600 drug overdose deaths in the United States involved an opioid, according to the Centers for Disease Control and Prevention (CDC.)

What are opioid drugs?

According to the National Institutes of Health, opioids include the illegal drug heroin as well as pain relievers available legally by prescription such as

  • oxycodone
  • hydrocodone
  • codeine
  • morphine
  • fentanyl

and many others. When opioids attach to brain cell receptors, the cells release signals that weaken your perception of pain and boost feelings of pleasure, according to the Mayo Clinic.

What causes opioid addiction in seniors and the disabled?

Anyone who takes opioids is at risk of developing an opioid addiction, according to the Mayo Clinic. Opioid addiction involves an irresistible craving for the drug and continued use of the drug despite repeated harmful consequences. According to the U.S. National Library of Medicine, opioid addiction and dependence are higher if you abuse the medicines. Abusive behavior includes:

  • taking more than your prescribed dose
  • taking medicine not prescribed to you
  • taking medicine differently from how it is prescribed
  • taking medicine with the intent to get high

According to the U.S. Department of Health & Human services, the two groups of Medicare beneficiaries who are at serious risk of opioid misuse are those who receive an extreme amount of opioids and those who appear to be “doctor shopping.” Extreme amount means more than two and half times the dose the CDC recommends avoiding for chronic pain patients, according to HHS. Doctor shopping involves receiving medically unnecessary opioids from multiple prescribers and pharmacies.

How does the opioid crisis kill seniors and the disabled?

High doses of opioids can slow your breathing and heart rate, which can lead to death, according to the Mayo Clinic. Other side effects of opioids are sedation, dizziness, nausea, vomiting, constipation, tolerance and respiratory depression, according to the U.S. National Library of Medicine.

What are laws regarding the opioid epidemic?

According to the New England Journal of Medicine, successful regulation of prescription opioids involves a difficult balance. Good laws can reduce misuse and overdose, therefore managing the opioid crisis without obstructing compassionate pain management. In 2016, the Centers for Medicare and Medicaid Services (CMS) implemented the Comprehensive Addiction and Recovery Act (CARA) to combat the opioid epidemic. CARA allows Medicare Part D sponsors to implement drug management programs which can limit at-risk beneficiaries’ access to frequently abused drugs.

Do you have questions about Medicare coverage of opioids?

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