State Changes Medicaid List, Treatment Advocates Angered

The Department of Health and Mental Hygiene has removed Suboxone Film from the state medicaid drug list and replaced it with Zubsolv — a move that advocates say will disrupt and limit treatment.

Both the Suboxone Film and Zubxolv work to taper opioid addiction but do so through different delivery methods. The film is a small sheet with medication that is dissolved under the tongue, will Zubsolv is a pill that is swallowed.

According to The Baltimore Sun the change was made, at least in part, due to the smuggling of the film into correctional facilities.

In a letter published in The Baltimore Sun last month, Van T. Mitchell, secretary of the state Department of Health and Mental Hygiene, said the move was largely to counter the smuggling of the film into Maryland correctional facilities.

“Smuggling has been extremely problematic,” he wrote in the letter, co-signed by Steve T. Moyer, secretary of the Department of Public Safety and Correctional Services. “Not only does it jeopardize prisoners’ health and safety but it also jeopardizes the security of correctional staff.”

Mitchell said the film has been “the most prevalent controlled dangerous substance” found in Maryland correctional facilities since 2014. Corrections officials seized 2,160 smuggled strips from January through May, up nearly 65 percent from the same period in 2015.

He also argued that the main ingredient in the film and pill, buprenorphine, remains available. The health department reports prescriptions of buprenorphine in all forms are rising — to 11,132 in 2015 from 5,631 in 2010.

The article reports reactions from treatment professionals who believe the change can destabilize and derail treatment:

The change “may destabilize their recovery,” Dr. Leana Wen, Baltimore’s health commissioner, wrote in a letter to Mitchell obtained by The Sun under public records laws. “Changes in medication formulation can and will lead to relapses, overdoses and deaths.”

Marian Currens, president of the Maryland Association for the Treatment of Opioid Dependence, representing about 80 treatment programs, has raised objections to the switch. She is a nurse practitioner with the Center for Addiction Medicine in Baltimore and says her Medicaid patients now have to receive Zubsolv while those with private insurance have more choices.

“Now it’s insurance-driven, not patient-driven,” she said.

Treatment providers fear that more recovering addicts could be derailed by the switch, which some said caught them off guard.

Dr. Christopher Welsh, an addictions psychiatrist, said the switch also caught some pharmacies by surprise and they did not stock enough Zubsolv, which comes in several dosage levels.


For more information read the full article The Baltimore Sun.

Previous Coverage on Conduit Street:

Op-Ed Warns Changes to State Medicaid Drug List Will Restrict Addiction Treatment