Patients on Medicaid are more likely to use illicit drugs, according to a large new study presented at PAINWeek, the nation’s largest conference for frontline practitioners in the field of pain management.
In an analysis of nearly two million urine drug samples conducted by Ameritox, over 17 percent of the Medicaid patients tested positive for an illegal drug such as marijuana, cocaine, heroin or PCP. That compares to 14.8% of the patents who “self pay” their own medical bills, 9.7% who have private insurance, 8.9% who are on Medicare, and 8.6% of the patients covered by workers compensation.
“The payer groups are proxies for socioeconomic status,” said Dr. Harry Leider, chief medical officer of Ameritox, one of the nation’s largest drug screening companies. Patients on Medicaid are more likely to be unemployed or low income, according to Leider, while patients who have private insurance are more likely to be employed and come from higher income groups. Still, the results indicate that there is use of illicit drugs regardless of economic status or age.
“Even in the Medicare population, clinicians should be concerned about illegal drugs being used in concert with opioids,” Leider told American News Report. “Many clinicians have this belief that if someone is older, you don’t need to worry about that stuff. And the data suggests that’s not true. It’s lower, but there’s still a concern that people could be mixing drugs that could be dangerous.”
Leider said there were “tremendous variations” in illegal drug use by state. Samples that came from Massachusetts had the highest rate of illicit drugs detected (21.7%), while Alabama had the lowest (6%).
Top 5 States With Illicit Drugs Present
- Massachusetts (21.7%)
- Michigan (21.1%)
- Washington (20.2%)
- Wisconsin (18.8%)
- Pennsylvania (17.1%)
Bottom 5 States With Illicit Drugs Present
- Alabama (6%)
- Louisiana (7.5%)
- Tennessee (7.9%)
- Virginia (9.2%)
- Texas (9.3%)
“I think there are some social norms that are different in certain states, where certain drugs are used more. In southeastern parts of the country, in Appalachia, there is more use of certain things like amphetamines,” said Leider.
Nationwide, more than one in three urine samples (35%) contained no evidence of a prescribed pain medication – indicating that patients are reluctant to use painkillers, may not need the drugs, or that the drugs are being diverted and used by other people.
The study was not peer reviewed and was conducted by Ameritox employees. It is based on urine samples submitted to Ameritox for testing from 2010 to 2012. Many of the samples came from pain clinics or drug rehab centers, so they are not representative of the general population.