Ohio Medicaid will carry more drugs for ‘dope sickness’

New medications seen as better for opioid withdrawal.

Ohio Medicaid COLUMBUS — officials plan to make more drugs available next year that alleviate the symptoms of opioid addiction and withdrawal.

Many Ohioans want freedom from their addiction but find recovery difficult. Without opioids, they go into withdrawal — known as “dope sickness” — insomnia, vomiting, diarrhea, body aches, headaches, muscle cramps, chills, anxiety, paranoia and other physical and mental difficulties.

In such a vulnerable state, it’s hard to stay clean. Many recovering addicts receive what’s known as medication-assisted treatment. Numerous drugs can keep dope sickness at bay while the addicts work on emotional and other aspects of recovery.

About 18,000 Ohio Medicaid enrollees were using medication-assisted treatment in 2017, as the opioid epidemic rages, according to state figures. About 3 million Ohioans are enrolled in the state-federal health care program.

Ohio Medicaid currently covers Suboxone and a generic drug with buprenorphine and naloxone, which are commonly used in treatment.

If doctors want to prescribe another drug, they have to get pre-authorized, Tracey Archibald, Ohio Medicaid’s pharmacy director, said during a Wednesday discussion with a committee reviewing the department’s formulary for 2019.

But the doctors are often denied, said Burt Dhira, executive director of the Ohio Addiction Treatment Council.

In the past three years, new medicines have come on to the market that are better for some patients, Dhira said.

For instance, Ohio Medicaid’s approved generic crumbles when cut in half, so doctors can’t tell patients to take half in the morning and half at night, Dhira said.

“It turns into pretty much chalk,” he said.

But new medicines can be cut. Absorption rates are different, which means dosages are different too, Dhira said.

Medicaid will have on its preferred drug formulary all drug combinations of buprenorphine/naloxone, which means no pre-authorizations.

But there are limits in terms of age, dosage and whether a woman is pregnant.

Some people take medication-assisted treatment drugs for a few months at the beginning of recovery. Some people are so hooked on opioids they take the drugs for longer.

Ohio Medicaid spends $63 million on medicine-assisted treatment drugs a year, before discounts and rebates are factored in.

The changes, which are to begin Jan. 1, are expected to increase spending by less than $5 million. Ohio’s Medicaid program in 2017 was nearly $26 billion. Ohio’s share was $8 billion.