Tamara Cicogna deals with chronic pain since being diagnosed with multiple sclerosis, but her experience with her loved one’s addiction to opioids has left her cautious when it comes to the painkillers.
“To me, the government was feeding his addiction,” Cicogna said.
Someone close to Cicogna was on Medicare because he was considered disabled, which Cicogna said gave him easier access to the drug.
“If you didn’t have the money and the Medicare to go and get the prescriptions, I don’t think that he could have fulfilled it," Cicogna said. "It would have been hard for him to steal and keep that upstanding citizen look. That’s what Medicare let him keep, that upstanding citizen look.”
Medicare is the largest payer of opioids in the United States since 2006, paying for between 20 to 30 percent of the drug’s cost, according to a 2016 report in the health care journal Health Affairs.
“Medicare Part D opened the Pandora’s box to opioid addiction, but it’s not so easy to close it," said Sam Hammond, poverty and welfare policy analyst for the Niskanen Center.
It was in 2006 that Medicare’s Part D program was enacted by former President George W. Bush to help beneficiaries pay for their prescription drugs.
"There are definitely different factors that play in, but what we’ve seen just post-2006 was a rapid acceleration in part because of an increase in access," Hammond said.
And hundreds of prescribers under Medicare Part D were identified as having questionable opioid prescribing patterns in a recent Health Department Inspector General report.
Cicogna's loved one told her he had battled addiction in the past, but she said it was not until the first time he disappeared for a week without explanation she realized it was still an issue.
“When he went to the doctors he looked nice. He looked like your neighborhood businessman. He never, he just didn’t look like somebody you would think was an addict," Cicogna said.
She said as time went on, her awareness of the problem grew, and so did the consequences.
“The deeper he gets strung out, the more you fear you don’t want him to come around because he has a temper, you don’t want him to steal, you don’t want him to be around your grandkids, and he starts looking like that scary addict,” Cicogna said.
The Center for Medicare and Medicaid Services said in an email to Circa they are working with stakeholders to address the opioid epidemic and come up with alternative solutions to pain management.
Hammond also said allowing prescriptions to use alternative treatment options for pain could be one solution to the problem.
“In states that have medical marijuana laws, if you come in with lower back pain you have an alternative substance to prescribe them,” Hammond said. “Other examples would be to provide, make it easier for medical professionals to prescribe Methadone.”
And years later Cicogna was not able to leave the opioids behind.
"When they’re giving you 90 days of hydro, and then they give you on top of that a prescription of OxyContin and then they want to give you Fentanyl patches, yeah I would have no trouble being an addict. And a legal one at that," Cicogna said.
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