Docs: Medicare failing addicted seniors
Plan doesn’t cover methadone to treat opioid abuse
Americans 65 and older battling substance use disorder do not have access to one of the best treatment options, according to local doctors.
Methadone, among the most effective and prevalent medications used to ween people off opioids, is not covered by Medicare for those looking to kick addiction.
“We are in the midst of a public health crisis of overdose and untreated addiction,” said Dr. Sarah E. Wakeman, medical director of the Massachusetts General Hospital Substance Use Disorder Initiative. “Methadone treatment is the beststudied and most effective treatment for opioid addiction. Access to this lifesaving treatment without any barriers is crucial for all people with this illness.”
One in three Medicare Part D beneficiaries was prescribed opioids in 2016, according to the Health and Human Services Office of Inspector General.
Medicare will in many cases cover methadone for pain management, but not for substance use disorder.
A 2016 National Survey on Drug Use and Health found 1.2 percent of people 65 and older were misusing opioids. Though this is lower than the 8.7 percent among those 18-25, there are still many members of the baby-boom generation dealing with the disease, said Dr. Manuel Pacheco, chief of the Emergency Service in the Department of Psychiatry at Tufts Medical Center.
“A lot of them were experimenting with substances in the ’60s, and they’re aging out right now,” Pacheco said. “We have a significant number of people in that group with substance use disorders.”
Methadone is generally given out at specialized clinics rather than retail pharmacies, which is one reason Medicare does not cover it, according to Dr. Michael Sinha, postdoctoral fellow in the Program on Regulation, Therapeutics, and Law at Brigham and Women’s Hospital.
“Failing to cover methadone for opioid use disorders ignores evidence that the drug can be an effective and inexpensive treatment,” Sinha said.
“Opioid use disorders affect people of all ages and socioeconomic backgrounds, and failing to cover methadone for opioid use disorders is especially problematic since Medicare is often willing to cover the drug for other uses.”