States should do more to pave the way for a new class of painkillers developed to resist abuse, a Virginia-based think tank argues in a report released today.
But a state legislator in Duluth is skeptical, saying it's more important to address the underlying causes of opioid abuse.
The report, titled "Optimizing the Abuse-deterrent Opioids Market," was released by the American Legislative Exchange Council, which bills itself as favoring limited government and free markets. It was written by Wayne Winegarden, a fellow with the Pacific Research Institute, also a free-market advocacy organization.
The so-called abuse-deterrent opioids - often referred to by the acronym ADFs - could be one of many tools needed to combat prescription opioid abuse, which was involved in 60 percent of drug overdose deaths in the U.S. in 2010, Winegarden said in a news conference on Tuesday.
"But current practices discriminate against the appropriate prescription of these drugs," he said.
The recently developed drugs, at least three of which have been approved by the Food and Drug Administration, are less likely - although not impossible - to be abused, Winegarden said. They fall in three categories:
• The "fortress approach," in which the medicine retains extended-release properties even if crushed or dissolved.
• The "neutralizing approach," which releases a neutralizing agent when tampered with.
• The "aversive approach," which produces an unpleasant side effect if a large quantity is ingested.
But current practices in many states discourage use of the drugs, Winegarden contended. For example, insurers or pharmacists often substitute a generic drug for a brand-name drug with abuse-deterrent properties, he said.
The cost of the new drugs is higher, Winegarden acknowledged, but he said generic versions are being developed and the costs will start to balance.
A bill requiring that insurers cover ADFs was proposed in the Minnesota Legislature last year.
But state Rep. Jennifer Schultz, DFL-Duluth, said she's unconvinced.
"They can change the formula and time release of the medication," Schultz said. "That's only a deterrent and doesn't mean it's going to prevent abuse. The real solution is to address the underlying issues" of why people abuse prescription drugs.
The Legislature appropriated $33,000 last year for the Department of Human Services "to convene an opioid prescribing improvement program," Schultz noted, and gave a 2 percent rate increase to chemical dependency providers.
She wouldn't support a bill on ADFs until she sees scientific support for their effectiveness, Schultz said. "I don't think there's any scientific studies that show that it's effective."
Winegarden acknowledged that available research is new and more is needed. But he cited two early studies that he said show about a 20 percent reduction in drug abuse.
The American Legislative Exchange Council, or ALEC, has been criticized for corporate ties, particularly by the Madison-based Center for Media and Democracy, which describes itself as an independent watchdog group.
Lisa Graves, the Center for Media and Democracy's executive director, said on Tuesday that although she wasn't aware of the specific report being released today, ALEC has "a long history" of being supported by the pharmaceutical industry.
Drug maker Pfizer is both a maker of one of the ADFs and a funder of ALEC, Graves said.
"The legislation may be ascribed publicly as an altruistic piece of legislation, (but) in many instances it serves a private interest," Graves said.
An ALEC spokeswoman said the organization is a nonprofit membership association of state legislators funded by "a combination of dedicated grants and membership dues."
"All ALEC research is produced by policy experts in their specific fields with the intent to inform the policy debates happening in statehouses across the country," spokeswoman Shana Sally said.