Oregon Medicaid Opioid Force Taper Policy Surfaces Again This Week

By Ed Coghlan.

Oregon’s Chronic Pain Task Force will gather in Wilsonville, Oregon Thursday morning (September 20).

The meeting will review written and verbal comments received during the August 9 Value-based Benefits Subcommittee meeting on the Chronic Pain Task Force’s controversial recommendation to force taper Oregon Medicaid patients off opioids in a year.

The recommendation—which includes covering more alternative treatments—was met with widespread criticism by chronic pain physicians, advocates and patients.

They received over 400 emails from patients and providers, plus the in-person protests at VbBS meeting and at Oregon Health Authority offices.

In its packet of information announcing the September 20th meeting, Oregon officials noted the “feedback was negative and focused on the perception that all patients with chronic pain, regardless of diagnosis, would be tapered off currently prescribed opioids”

One of the national leaders who attended the August meeting was Bob Twillman, Executive Director of the Academy of Integrative Pain Management who told the National Pain Report that he hopes the task force will consider two things.

“First, that while there is little high-quality evidence that long-term opioid therapy is effective in treating chronic pain, that doesn’t mean that some patients don’t benefit from that therapy—i.e., the absence of evidence is not evidence of absence,” he said.

“There, likewise, is little high-quality evidence that patients receiving long-term opioid therapy experience a net benefit if their therapy is tapered involuntarily. The OHA has been conducting an experiment with respect to opioid tapering among people with neck and back pain for nearly two years now, and I believe they need to demonstrate that patients subjected to that experiment have benefitted significantly before they impose a taper program on any other patient group. I completely support expanding coverage for non-pharmacological treatments for people with chronic pain, but this is not a “both or neither” situation—it is possible to increase that coverage without mandating an opioid taper.”

Twillman believes that the patient voice needs to be heard.

“A much better approach, in the absence of evidence regarding the impact of their ongoing back pain experiment, is to expand non-pharmacological treatment coverage and to educate patients about the risks of opioid therapy so they can decide, with their providers, if they will voluntarily attempt to taper their opioid dose.”

Chronic pain advocates hope that they can bolster attendance at the meeting on the 20th. The public also may attend via a listen-only conference line by calling 888-204-5984, participant code 801373. The meeting starts at 9:30 a.m. Pacific Time.

Leave a Comment