- Colorado is making strides in improving patient access to opioid treatment, but will require further progress to truly address the opioid crisis, according to a spotlight analysis of the state by Manatt Health in partnership with the American Medical Association (AMA) and Colorado Medical Society (CMS).
Specifically, the state has excelled in improving access to evidence-based treatments, worked to develop better pain management treatment for chronic pain patients, and increased access to the overdose-reversing drug naloxone.
Ideally, this progress can serve as a best practices guide for states also looking to address the opioid crisis, said AMA president-elect Patrice A. Harris, MD, who also chairs the AMA Opioid Task Force.
“We conducted this analysis because it’s essential that policymakers know what is working, and where additional progress can be made,” Harris stated. “Colorado has implemented many important policies that are impacting patients’ access to care. Using this momentum, we think Colorado can go even further to save lives of those affected by opioid use disorder.”
Colorado is succeeding in four key areas, the report explained.
First, it has effectively shaped policies and set aside funding to increase access to medication assisted treatment (MAT). Past studies have indicated that MAT is the leading treatment for opioid addiction. Colorado’s actions work to reduce administrative burden, address clinician workforce issues, and increase Medicaid MAT coverage in residential areas.
Second, Colorado has examined mental health and substance use disorder parity laws. Most laws state that there must be equal access to both mental health and substance use disorder treatments, and Colorado has made progress in examining compliance in this area.
Additionally, the state has increased Medicaid patient access to non-opioid pain management treatments. Data from the Substance Abuse and Mental Health Services Administration (SAMHSA) states that 80 percent of opioid addictions began with a legal prescription to a painkiller. Looking to alternatives to those painkillers can quell opioid misuse before it develops.
Finally, Colorado has created policies to make it easier for patients to access naloxone. Specifically, the state has created Good Samaritan protections, reduced prior authorization regulations, and created a standing order for naloxone.
Going forward, Colorado officials plan to look at how the above-mentioned policies are working to improve patient care access and identify improvement areas.
“This analysis comes at an important time for Colorado,” said Dr. Debra Parsons, CMS president. “Over the last six years, Colorado has developed policies, enacted laws and made important strides to have all stakeholders work together to reverse the opioid epidemic. While we continue these successful initiatives, we must closely evaluate how they are working so we can ensure we are putting our efforts in the right places.”
Specific areas for improvement identified in the report include steps to enforce mental health and substance use disorder treatment parity. Additionally, Colorado must do more to expand rural patient access to MAT providers.
State leadership can create statewide pilot projects to test multimodal pain treatment, as well as new formulary and benefit design that would connect more chronic pain patients with non-opioid treatments.
Finally, leadership must evaluate state policies to identify strategies that are and are not working to improve patient care.
Much of this will require Colorado state officials to collaborate more closely with commercial payers, according to Michael Conway, Colorado Insurance commissioner and head of Colorado’s Division of Insurance.
“Many of the recommendations in this report related to commercial insurance—such as strengthening our market conduct examinations to better enforce mental health parity and more comprehensive front-end reviews of the number of addiction professionals in insurers’ networks—are fair and reasonable approaches that are within our authority to immediately tackle,” he pointed out. “We look forward to working with Colorado’s health insurers and physicians to implement solutions that help ensure consumers receive the care that they need to help end our state’s opioid epidemic.”
This report is the second of a series from Manatt Health and AMA exploring statewide policies for addressing the opioid crisis. In December 2018, the organizations published a similar report commending Pennsylvania’s policies for supporting opioid treatment access.
Pennsylvania, like Colorado, leaned on expanding patient access to MAT, naloxone, and mental healthcare services.
“We are pleased to see this study highlight the important progress Pennsylvania is making in our ongoing battle against the opioid crisis,” Governor Tom Wolf said. “By expanding access to naloxone and medication-assisted treatment, among the many initiatives of our Opioid Command Center, we are rescuing more people and getting them into treatment and recovery.”