Monday, September 13, 2010

Psycho Drugs Popular With Medicaid Recipients

If you thought drugs to treat common diseases like heart, cancer and diabetes are the most commonly prescribed drugs for Indiana's Medicaid recipients, think again. It's the psycho drugs used to treat bipolar disorder, schizophrenia and attention deficit order in adults and children. The Indiana Legislative Insight makes this profound observation in its most recent edition. The legislative newsletter notes figures showing Indiana's Medicaid program spent more money on drugs to treat schizophrenia and bipolar disorder during the most recent quarter ($14 million) than any other drugs, a 25% increase over the prior quarter. On an annualized basis, the newsletter finds the state is spending $75 million to cover some 49,000 claims. Equally as disturbing is the disclosure that the most commonly prescribed drugs under the program are for treatment of pain using prescription drugs like Vicodin or Lortab, which are known for their addictive nature. There were 131,870 claims for pain-killers during the first quarter alone. ILI writes:

We don't pretend to understand much about what these numbers mean, nor about the implications of the data.What is clear, however, is that the state's Medicaid program is paying out a lot of money to mitigate the effects of schizophrenia and bipolar disorder; for meds to treat high-risk children (and you can draw your own conclusions about what prevention efforts aimed at parents might save in dollars alone in that respect); and for drugs to treat ADD in children and adults, despite popular debate over whether this is a real medical condition needing treatment, and whether administering such meds – to children in particular – is an appropriate long-term treatment strategy.
ILI's observations reminded me of a complaint former FSSA employee Carl Moldthan had made to me about in my earlier post about his view of FSSA's failed privatization of welfare services in Indiana. He mentioned how county welfare workers thought there were far too many disability claims for bipolar disorder that were being approved. In some offices, Moldthan noted as many as half of the claims were for bipolar disorder. Moldthan had recommended an independent medical review team to determine eligibility for those claims because there was a feeling among some county welfare workers that too many physicians were simply saying what their patients wanted them to say in order for their patients to qualify for the benefits.

11 comments:

Eclecticvibe said...

Doesn't it make sense that people who suffer from mental illness are the most likely to need government assistance? Mental illness often leads to unemployment and homelessness. Mental health care is often not covered by standard insurance plans. As mental health issues become more recognized as a valid medical condition, it is not surprising to see a rise in the treatment of such conditions. People who suffer from severe mental illness often live with us in society, as opposed to the institutionalization they once faced. Society has decided that treating mental illness through programs like medicaid are better answers that state run mental health institutions. Quite frankly I'm glad that people suffering from schizophrenia and bi-polar disorder are receiving treatment. I'm also glad that we under stand that mental illness is a condition that must be treated just like any other disease. Medication may not be the best or only solution, but it certainly seems like an appropriate part of the care of those with mental illness.

Cato said...

People see the doctor when they're hurt, so painkillers seem like an obvious and common prescription.

It's sad we need to get someone's permission to reduce our pain. Free country? Yeah, right.

Advance Indiana said...

Most of us settle for aspirin, tylenol or one of the many other over-the-counter drugs for pain. People shouldn't be prescribed these other narcotic painkillers unless they are suffering unbearable pain. It's no wonder so many people are knocking off drug stores to feed their addiction to painkillers.

Cato said...

I'm not fit to tell another man how he should relieve pain or make his lot more comfortable.

Saying "they shouldn't be prescribed" further adds to the problem, as people must take extraordinary measures to obtain that which the government has prohibited. This mentality further entrenches the state of the people as dependents upon governmental leave and permission for their activities.

If we are the masters of anything, it is ourselves.

"Setting any law in opposition to human nature is the highest form of cruelty." Thomas Jefferson

Jeffrey said...

As pointed out in findrxonline Equally disturbing is the revelation that the most commonly prescribed drugs for the treatment of pain with a prescription such as Vicodin or Lortab, which are known for their addictive nature.

interestedparty said...

Bi-polar or schizophrenia often manifest or are diagnosed in young adulthood, likely in people who are not functioning well in regards to capacity work/career/job. This is about the age when they have "aged out" of their parents health insurance.

Perhaps the new Health Care Reform will help keep them on their meds, which I have heard sometimes take trial and error to find the right ones at the right dosage.

Marycatherine Barton said...

I do not know what to make of these statistics. Very perplexing!

intellectualoid said...

I generally love your blog, but don't understand why you find it disturbing that people on Medicaid may need medicine for mental illness. Eclectevibe is right.

Advance Indiana said...

I would expect some people to be on the drugs, but it is disturbing that those are the most commonly prescribed drugs given the leading causes of death in Indiana. The problem is not limited to the Medicaid population. I think they are being increasingly over-prescribed among all social classes in this country. Nearly 20% of the American population has been prescribed a psycho drug of one form or another. I think it goes hand in hand with a trend towards people not accepting personal accountability for their actions. If a doctor says you have a mental problem that can be treated with drugs, then people feel they can excuse their bad acts. Phyllis Stevens embezzles $5 million from her employer and then pleads insanity because she found a doctor who will say she suffers from multiple personality disorder. She was perfectly fine until she got caught.

interestedparty said...

Come to think of it, I'm not sure about this, but is it accurate to lump pain medications with "psycho drugs"? Is it meant to imply pain is a "psycho" problem. What does "psycho drug" mean anyway?

informatics411 said...

Are you really quoting a non-scientific source that seriously, and without scientific literature to back up a claim, makes a statement about a medical diagnosis, without being a physician, researcher or paid staffer for a giant pharmaceutical company?

As is often quoted these days, everyone in America is entitled to her/his opinion; none of us are entitled to our own facts. There is no medical dispute regarding the illnesses listed in your blog posting. There is plenty of untrained, non-medical commentary about them; but I've not read any legitimate peer-reviewed study (which stands up to scrutiny) that seriously questions the conditions you raise.

One should praise health coverage for any so-called mental illness in Indiana. It's a difficult and hard fight for anyone who suffers from a neurological condition to make it through a "normal day," much less have to fend off the gripes and jealousy of folks who have no neurological difficulties...but just want to moan about something. (They should spend a day in the shoes of some of those I've met along the way; they wouldn't survive one hour!)

And, c'mon AdvanceIndiana: quoting a comment from a former official about corruption, or even anecdotal evidence about a criminal who happens to rely on a psychological diagnosis - neither has any bearing whatsoever on the actual medical research regarding the conditions mentioned in the blog. This isn't even an apples and oranges comparison; it is an Apple computers and orangutans comparison, e.g., not even some category of objects in the world...

That would be using non-scientific evidence to counter scientific evidence.