Tag Archives: Vivitrol

What We Are Reading This Week From Across the Nation

A lot of reporting in the treatment space over the past few days, and we appreciate the Kaiser Family Foundation for aggregating the stories so we can provide them to you here.

  1. Drug Overdose from Fentanyl Spinning Out of ControlThe New York Times: The First Count Of Fentanyl Deaths In 2016: Up 540% In Three Years
    Drug overdoses killed roughly 64,000 people in the United States last year, according to the first governmental account of nationwide drug deaths to cover all of 2016. It’s a staggering rise of more than 22 percent over the 52,404 drug deaths recorded the previous year — and even higher than The New York Times’s estimate in June, which was based on earlier preliminary data. (Katz, 9/2)
  2. Controversial Nomination for Director of Office of National Drug Control Policy
    Stat: Trump Nominates Republican Congressman Tom Marino As Drug Czar 
    President Trump on Friday nominated Rep. Tom Marino (R-Pa.) to lead the Office of National Drug Control Policy as the nation’s “drug czar,” months after he had officially withdrawn from consideration. Marino, an attorney who has served in the House of Representatives since 2011, has a lengthy track record of supporting enforcement-side drug policy as well as improved drug treatment. (Facher, 9/2)
  3. Abuse of OTC Drugs Can Be Harmful As Well
    The New York Times: Opioids Aren’t The Only Pain Drugs To Fear 
    Last month, a White House panel declared the nation’s epidemic of opioid abuse and deaths “a national public health emergency,” a designation usually assigned to natural disasters. A disaster is indeed what it is, with 142 Americans dying daily from drug overdoses, a fourfold increase since 1999, more than the number of people killed by gun homicides and vehicular crashes combined. A 2015 National Survey on Drug Use and Health estimated that 3.8 million Americans use opioids for nonmedical reasons every month. (Brody, 9/4)
  4. Private Equity Continues Investment in Drug Treatment Facilities in 2017
    The Wall Street Journal: Private-Equity Pours Cash Into Opioid-Treatment Sector 
    Private-equity firms are piling into a new business opportunity: the opioid addiction crisis. Drawn by soaring demand, expanded insurance coverage and the chance to consolidate a highly fragmented market, firms plowed $2.9 billion into treatment facilities last year, up from $11.4 million in 2011, according to research firm PitchBook Data Inc. The number of private-equity deals rose to 45 from 25. (Whalen and Cooper, 9/2)
  5. The Science of Addiction – Do We Finally Have the Tech to See Inside the Brain?
    The Washington Post: Addiction And The Brain 
    Today’s war on drugs isn’t fought by first ladies or celebrity advocates. Armed with MRI machines, electromagnetic pulses and experimental drugs, scientists are on the battle’s front lines. In the cover story of September’s National Geographic, Fran Smith explores the different fronts of a war being fought in laboratories and universities all over the world. Armed with the tools of science and with the help of people who struggle with addictions to substances and self-destructive behavior, researchers are working to unravel the mysteries of the addicted brain. (Blakemore, 9/2)
  6. Crystalmeth Continues Its Journey Outside Rural America and Into Our Cities.
    The Wall Street Journal: Drug Traffickers Push Meth Into New York City  
    Mexican traffickers are supplying the New York City area with methamphetamine, attempting to create new clients in what historically has been a weak market for the drug. “The Mexican cartels have been sending loads up to New York and telling traffickers, ‘See if you can get customers,’ ” said James Hunt, special agent-in-charge of the Drug Enforcement Administration’s New York division. “They want to create an addict population.” (Ramey, 9/4)
  7. Vivitrol Marketing Continues to Capture the Attention of State Funded Programs.
    New Orleans Times-Picayune: Louisiana Prisons Start Administering New Drug To Treat Opioid Addicts  
    The use of Vivitrol is the latest trend in opioid treatment. In the first quarter of 2017, Vivitrol sales totaled $58 million, a 33 percent increase over the previous year, according to a June report by ProPublica. Several state prisons, including those in Illinois, Wyoming and Wisconsin, started administering the drug to inmates last year. Even more drug courts and local jails are using it: ProPublica tallied up more than 450 public Vivitrol initiatives in 39 states. (O’Donoghue, 9/1)
  8. The War on Drugs and Caring for the Addicted Inmate.
    The Baltimore Sun: Baltimore County Facing Higher Costs For Inmate Care Due To Addiction, Mental Health Services  
    The cost of providing medical care for inmates at the Baltimore County jail in Towson is rising more than 50 percent — several million dollars a year — due primarily to an increase in inmates and detainees with opioid addiction, mental illness or chronic diseases. The County Council is set to vote Tuesday on a contract for a private company, PrimeCare Medical, to manage medical, dental and behavioral health treatment for the jail’s roughly 1,200 inmates. (Wood, 9/5)
  9. Recovery High Schools – the Continuation of Recovery Educated-Based Programs.
    St. Louis Public Radio: New Missouri High School Will Help Teens Struggling With Addiction Avoid Temptations 
    Teens who struggle with drug and alcohol abuse face many temptations after complete treatment. A new private high school opening soon in suburban St. Louis will offer them an educational environment free of some of those potential triggers. (Delaney, 9/4)
  10. Is Insurance Also to Blame for Addiction?
    Idaho Statesman: Insurers Tell Idaho Pain Patients: Try More-Addictive Drugs 
    In at least three cases, patients with Regence BlueShield of Idaho plans were denied Radnovich’s choice of a Butrans patch — a long-acting version of the opioid buprenorphine that is “Schedule III,” with a “moderate to low potential for physical and psychological dependence.” Instead of the patch, Regence was willing to pay for a fentanyl patch or morphine tablets. (Dutton, 9/4)

Opioid Emergency, Deductible Waivers,… and Methadone?

On May 3, 2017, the Governor of the State of Florida signed Executive Order Number 17-146 declaring that the opioid epidemic threatens the State with an emergency and that, as a consequence of this danger, a state of emergency exists. Also, in the executive order, the Governor directed the State Health Officer and Surgeon General to declare a statewide public health emergency, pursuant to its authority in section 381.00315, F.S. On June 29, 2017, the Governor signed Executive Order Number 17-177 to extend the state of emergency declaration.

The Department of Children and Families (DCF) was recently awarded a two-year grant to address this opioid epidemic.

Many Floridians involved in this discussion were excited that expansive use of Medication-Assisted Treatment and other modalities would be used to address the growing epidemic within underserved populations using a medical model, rather than exclusively through traditional counseling treatment.

However, what appears to be occurring, though more information still needs to be obtained, is that DCF will use these funds in part to expand onlyMethadone Medication-Assisted Treatment services in needed areas of the state as part of a comprehensive plan to address the opioid crisis. We do not believe this includes Suboxone or Vivitrol.

This also does not appear to help the majority of Floridians who may have insurance but cannot cover the costs of treatment due to treatment plans that continue to demand exorbitant co-pays and deductibles for SUD treatment. Stated otherwise, you either have SUD or do not. The economic decision of whether to pay a deducible becomes secondary.

While Florida does allow a statutory “deferral” of payment of deductibles in order to obtain payment, this allowance has been sometimes abused in the past with faux attempts to collect the deductible after-the-fact.

Florida mandates “balance billing” which means the provider MUST use all reasonable methods to collect on the balance. The fees for services are published and provided in advance as required by DCF rule, so the patient and their family know or have access to know what they are getting themselves into.

Ironically, perhaps, the “bad” providers who “forgive” the debt are alleged to have committed “Patient Brokering” for “inducing” a patient to treatment under the guise of waiving the co-pays and deductibles.

The “good” providers that follow the law and make every reasonable attempt to collect on the deductibles are called “heartless” or “ruthless” for “taking advantage of a family who is otherwise suffering a health tragedy.”

This law certainly must be changed.

For now, DCF has to revise the licensure requirements since methadone programs were the only type of service provider issued licenses based upon a needs assessment.  DCF has determined there is a critical need for more methadone medication-assisted treatment providers.

This rule makes changes to permanent Rule 65D-30.014 F.A.C., which is attached for reference, relating to licensure requirements for methadone medication-assisted treatment programs.