Medicare Is Cracking Down on Opioids. Doctors Fear Pain Patients Will Suffer.

Medicare's plan to deny payment for long-term, high-dose opioid prescriptions has provoked criticism from many people who would be directly affected by it, including those with chronic pain, primary care physicians, and experts in pain management and addiction medicine, reports the New York Times . The new Medicare rule means Medicare would deny coverage for more than a week of prescriptions equivalent to 90 milligrams or more of morphine daily, except for those with cancer or in hospice. The Centers for Medicare and Medicaid Services estimates that about 1.6 million persons currently have prescriptions at or above those levels. A Medicare official says the limit for monthly high doses was intended not only to catch overprescribing physicians, but also to monitor people accumulating opioid prescriptions from several doctors. Critics say the regulation could make people who lost access to opioids go into withdrawal or force them to buy dangerous street drugs. "The decision to taper opioids should be based on whether the benefits for pain and function outweigh the harm for that beneficiary," argues Albert Einstein College of Medicine Professor Dr. Joanna L. Starrels. "That takes a lot of clinical judgment. It's individualized and nuanced. We can't codify it with an arbitrary threshold."