Medicaid Policies Restrict Opioid Addiction Treatment

By McCarton Ackerman 07/16/13

Some experts say limited access to opioid addiction meds could put addicts' lives in danger.

Opioid replacement therapy like methadone
can save lives.
Photo via

Policies by Medicaid and private insurers have severely limited the availability of medication used to treat opioid painkiller addiction, and some experts are saying limited access to these drugs could put addicts' lives in danger. According to a new report from the American Society of Addiction Medicine, Medicaid agencies in just 28 states cover all three of medications that the Food and Drug Administration (FDA) has approved for opioid addiction treatment: methadone, buprenorphine and naltrexone. States that cover all three still require procedures which limit access, including prior authorization and re-authorization, imposing lifetime limitations and tapering dosage strengths. "Now that we finally have medications that are shown to be effective and cost-effective it is shameful to throw up roadblocks to their use," says Mady Chalk, director of the Center for Policy Research and Analysis at the Treatment Research Institute. Mark Publicker, a doctor in Portland, Maine, says the current restrictions could prove life-threatening: "People will die." Maine state Rep. Elizabeth Dickerson, a Democrat who introduced a bill this year to continue lifetime restrictions on methadone, argues that state methadone programs set Maine back $15 million annually. She worries that addicts could simply be replacing one drug for another and recommends that those who want methadone "should have to pay for it themselves." However, Mark L. Kraus, a Connecticut doctor who practices addiction medicine, believes that "the cost for not treating is far higher for the state than treating." According to The Centers for Disease Control and Prevention, 12 million Americans used opioids for non-medical reasons in 2010. Between 1999 and 2008, the number of opioid-related deaths tripled to 14,800.

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McCarton Ackerman is a freelance writer and editor living in Portland, Oregon. He has been a contributor for The Fix since October 2011, writing on a wide range of topics ranging from medical marijuana in Colorado to the world's sexiest drug smugglers. Follow him on Linkedin and Twitter.