MINNEAPOLIS _ A statewide crackdown on opioid prescribing appears to be working, even ahead of enforcement plans that would penalize doctors who dole out too many addictive painkillers.
New opioid prescriptions have declined 33% since 2016 for Minnesotans who receive health benefits from the state's programs for the poor and disabled, the Minnesota Department of Human Services announced Friday.
Prescriptions of opioids at dosages above new state's guidelines have been cut in half as well.
"Opioids remain an important tool to treat pain, but only when the benefits outweigh the risks," said Human Services Commissioner Jodi Harpstead.
Opioid prescribing levels have been lower in Minnesota than other states in the grip of a nationwide overdose epidemic, but the consequences have been severe in this state. Opioid-related overdose deaths surged from 54 in 2000 to 422 in 2017.
Many deaths are due to illicit heroin, or to fentanyl _ a potent opioid that is often abused _ but health officials have reported that many addictions started with common painkillers such as oxycodone and hydrocodone for treatment after surgeries or accidents.
The state created a prescribing working group in response, which set guidelines and dosage levels for prescribing opioids. They cover the acute phase following surgery or an accident; the short-term recovery phase after that; and the long-term chronic phase for any patients who continue to suffer pain. Doctors received their first personalized reports earlier this year to compare their prescribing levels with state averages, and are receiving updates now.
Doctors with excessive prescribing rates risk being removed from the state's network of doctors for its Medical Assistance and MinnesotaCare programs.
Patients suffering chronic pain have been wary of these reductions, because they fear that doctors will no longer prescribe opioids that have been their lifelines. State officials have acknowledged concerns over this population of existing chronic pain patients who have are dependent on opioids and unlikely to benefit as much from alternative forms of pain management.
Several pleaded their case in recent e-mails and testimony to the working group.
A Duluth woman with chronic lower back pain complained that her activity levels and happiness declined after her doctor started reducing her opioid dosage in 2016 in response to new government prescribing guidelines.
"I live in fear of my medications being lowered again or taken away with no resources to help," she wrote.
Other patients complained of difficulties finding doctors willing to prescribe them opioids, or of existing doctors trying to dump them because they no longer wanted to be responsible for their opioid prescriptions. Some admitted to thoughts of suicide.
"My cat gets better pain management than I do after surgery," said one man, who complained that one doctor cut off his opioids without any alternative plans for pain management.
