While most doctors in Michigan believe the state’s new rules for prescribing opioids will help to address the overuse epidemic, only 20 percent have been trained in Medication-Assisted Treatment and nearly two-thirds said they aren’t interested in getting trained.
Those were the results of a recent survey of some 600 primary care providers by the Center for Health and Research Transformation (CHRT) at the University of Michigan to gauge sentiment of the state’s 2017 efforts to deter over prescribing, including mandatory use of the Michigan Automated Prescription System (MAPS).
“CHRT’s physician survey shows that Michigan’s new requirements for MAPS reporting are generally supported by primary care physicians in Michigan. However, physician interest in Medication-Assisted Treatment is low, and more will need to be done in order for MAT to be a viable treatment option for the many Michiganders in need of help,” the report concludes.
“Between 1999 and 2016, the number of overdose deaths in Michigan increased 17 fold — from 99 to 1,699. In 2017, more deaths were due to overdose than car accidents,” the report states.
In 2017, state lawmakers passed several bills aimed at curbing the epidemic, notably limiting opioid prescriptions to seven days and requiring physicians to look up their patients’ prescription history on the MAPS statewide database.
Sixty percent of physicians surveyed agreed with the statement that the policies will “help address the opioid epidemic,” while 26 percent disagreed. Sixty percent said the policies will be “useful to better manage opioid prescribing,” while 22 percent disagreed.
Seventy percent said they also added an “unnecessary administrative burden,” while 17 percent disagreed.
Further, 55 percent agreed the policies will “limit ability to treat chronic pain,” 30 percent disagreeing. Fifty percent said the policies will “limit ability to treat acute pain,” with 34 percent disagreeing.
The Michigan Department of Health and Human Services has also tried to encourage more MAT programs. Doctors must get eight hours of training to prescribe buprenorphine, a drug used to treat opioid addiction and prevent symptoms of withdrawal. DHHS provided more than $7 million for MAT training, rate incentives and program expansions in rural areas. Recently, DHHS announced a tuition reimbursement program for the training, according to the report.
Still, the survey found 20 percent trained, and only 16 percent are interested in getting the training. The remaining 64 percent said they were not interested.
The numbers varied little depending on whether the doctor was located in an urban or rural area. Only 20 percent of urban doctors were trained; 63 percent were not interested. Some 23 percent of rural doctors were trained; 65 percent were not interested.
Younger doctors were more interested.
“. . . Physicians who began practicing within the last 10 years — the timeframe within which opioid-related mortality has risen to epidemic proportions — are significantly more likely to be providing or to be interested in providing MAT to treat (opioid use disorder), suggesting that the culture of medicine may be shifting in response to the fallout from the opioid epidemic,” the report states.
Among those practicing less than 10 years, 24 percent had the training and 26 percent were interested. Still, 50 percent said they were not. Among those practicing 20 years or more, 19 percent had the training and 16 percent were interested. Some 65 percent said they were not.
There was also a difference depending on whether the doctor had a large volume of Medicaid patients. Only 18 percent of doctors had the training if their patient volume was less than 30 percent Medicaid, with 14 percent saying they were interested. Some 69 percent were not if they had a low number of Medicaid patients.
For those with more than a 30 percent Medicaid patient volume, 28 percent already had the training and another 22 percent said they were interested. Still, 50 percent said they were not.
This story presented in cooperation with MIRS, a Lansing-based news and information service.