“The life-threatening adverse effects have raised serious concerns regarding the appropriateness of the widespread use of methadone for the treatment of chronic pain, particularly given the availability of alternatives that have been associated with less risk of overdose,” wrote the Senators in their letter to CMS. “These state Medicaid policies may be inadvertently contributing to opioid overdose deaths. State Medicaid programs play a significant role in providing access to quality health services for low income families and should continue to ensure the safe, appropriate and effective use of medications among the Medicaid population.”
Nationally, methadone accounts for only two percent of opioid pain reliever prescriptions but 30 percent of related overdoses. Because of methadone’s drug properties, the risk of overdose is disproportionally higher than other opiate pain relievers. And because of its low cost and status of as a preferred pain reliever in most state Medicaid programs, methadone is widely prescribed as a first option for the treatment of pain. The Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), and leading medical specialty societies representing pain medicine providers have all stated that methadone should not be used as a first line therapy for pain relief. There are currently 30 Medicaid state programs, including Maine, that list methadone as a preferred drug for the treatment of chronic pain.
The letter was led by Senator Ed Markey (D-Mass.) and was also signed by Senators Kelly Ayotte (R-N.H.), Tammy Baldwin (D-Wisc.), Shelley Capito (R-W.V.), Diane Feinstein (D-Calif.), Joe Manchin (D-W.V.) and Patty Murray (D-Wash.).
A copy of the Senators’ letter to CMS can be found HERE.
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