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Health insurers in Germany help prevent opioid crisis

Written by Diane Archer

Shefali Luthra reports for Kaiser Health News on how health insurers in Germany have helped prevent an opioid crisis there. How? They require doctors to prescribe alternate treatments before prescribing opioids. Not surprisingly, Germans are far less likely to die from opioid overdoses as Americans. In 2016, ten times as many Americans died of opioid overdoses as Germans.

The US, unlike most European countries, leaves it to local actors to decide whether and how to implement prescription drug protocols. In Europe, generally, national protocols are implemented throughout the country. These protocols tend to be developed by independent experts, scientists and patients.

In Germany, opioid protocols were developed with input from many scientific societies and patient groups. In addition to the protocols, Germany and other countries rely on patient education campaigns.

In the US, every state except Missouri has a prescription drug monitoring program, electronic databases that require reporting on and tracking of opioids and other controlled substances, such as benzodiazepines and amphetamines. But, some states have far more lenient reporting requirements than others. Those states that do not have reporting mandates show no sign of reducing opioid use.

States with comprehensive mandates requiring every provider to register and use these programs have lower rates of use of these drugs. One recent study reported in Health Affairs found a nearly 9 percent decrease in opioid prescriptions, as well as 4.27 percent fewer hospital stays and 17.75 percent fewer opioid-related emergency department visits in states with comprehensive mandates.

Still, unlike in Germany, addiction rates are rising in the US, even in states with comprehensive mandates. Experts suggest that the reason is that Germany has a different approach to health care and treatment for substance abuse. The primary distinction it appears is that health insurers in Germany, unlike the US, do not support opioid prescriptions in many instances unless other forms of treatment do not work. And, doctors in Germany must get special permission to prescribe opioids.

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