INCREASE IN HIGH-RISK OPIOID USE, FATAL OVERDOSE AS MORE MEDICARE RECIPIENTS DISPENSED MEDICAL GOLD STANDARD CURE
The 32 percent increase in medical providers ordering buprenorphine for Medicare enrollees in 2023 predictably associated with no benefit, instead increase in opioid overdose
by Clark Miller
Published May 9 , 2025
Okay, here we go, again.
Per the OIG report,
In 2023, about 53,000 Medicare Part D enrollees experienced an opioid-related overdose. This is the number of Part D enrollees who received medical care for anopioid overdose, such as in an emergency department, that was billed to Medicare. These overdoses represent non-fatal and fatal events.
Overdoses occur when high doses of opioids—alone or in combination with other substances—cause breathing to slow to dangerous levels or to stop altogether. Most fatal opioid-related overdoses nationwide involve synthetic opioids, such as illicit fentanyl.
The number of Part D enrollees who experienced an opioid-related overdose was slightly higher in 2023 compared to 2022. It grew by 3 percent.
Those are distortions, lies, that opioid overdoses (= high risk opioid use) increased “slightly” for the period and population studied, the acknowledgment of that buried in note 1.
1. Specifically, 53,165 Part D enrollees experienced an opioid overdose billed to Medicare in 2023. The total number of enrollees who had an opioid overdose is likely higher, given that enrollees who had an overdose and did not receive medical care billed to Medicare are not captured in this analysis. Further, if an enrollee’s claim had yet to be submitted to Medicare at the time that claims data were analyzed for this report (December 2024), then their overdose would not be identified.
“had an overdose and did not receive medical care billed to Medicare are not captured in this analysis”
The period of observation and data collection – 2023 – is synchronous with the major national surge in intensive, targeted, successful community naloxone distribution and training campaigns in many states and locales that are established as accounting for dramatic drops in fatal opioid ODs over past years. Those campaigns and the evidence also establish dramatic shifts and increases in potentially fatal overdoses that have been reversed by peers and community laypersons – not involving medical care, emergency response. or medical billing, consequently not formally recorded – and are described in multiple posts and for diverse states and locales here, and include –
From one of those posts –
As for the 6,600 overdose reversals, that’s likely an undercount, said Dr. Natasha Bagdasarian, Michigan’s chief medical executive.
“Most overdose reversals happen at 2 in the morning, when no one is calling the police, and no one is calling for help,” agreed Andrew Coleman, a site supervisor at the Sterling Heights office of the Arab Community Center for Economic and Social Services, or ACCESS, which also distributes naloxone.
Regular drug users have learned to take care of each other in an overdose, he said
“They see their friends falling out; they are turning blue, and they are Narcaning their friends,” he said. “But you’re not calling police if you’re with a group of people around who are involved with felony-level drug activity.” So those reversals never get recorded by the state.
That is, the evidence is clear – the OIG report’s 3 percent increase in opioid (fatal + nonfatal) overdoses in 2023 from 2022 is instead a much larger figure, 3 percent a significant underestimate.
And the true value, including non-fatal overdoses, represents, as such, an increase in high-risk opioid use = gold standard treatment failure.
That dramatic shift away from medically involved and recorded uses of naloxone for overdoses and toward increasing, undercounted layperson saves is consistent with increases in distribution of naloxone to Medicare recipients in 2023, “a record high”.
The salient fact here, of course, is that for this subpopulation of Medicare recipients, high-risk opioid use (as indicated by non-fatal + fatal overdoses) increased significantly and predictably in 2023 over a period of a “markedly higher” numbers of medical providers dispensing the common street currency for fentanyl, “subs”, also known as “buprenorphine”.
In 2023, a total 58,357 providers ordered buprenorphine for enrollees through Medicare Part D. This total represents a 32-percent increase from 2022 and was markedly higher than increases in recent years. Between 2020 and 2022, the number of providers ordering buprenorphine through Part D increased 12 percent each year. The larger increase in providers in 2023 may be due to the repeal of the buprenorphine waiver requirement.
Also consistent with the lethal results outlined in this OIG report tied to medical dispensing of buprenorphine, established as generally fueling rather than comprising “treatment” for problem opioid use, are demographic differences in enrollee receipt of medically prescribed buprenorphine.
At the same time, older enrollees—i.e., those aged 65 and above—were also less likely to receive medication to treat their opioid use disorder than were those under the age of 65. In 2023, 12 percent of older enrollees received medication, compared to 30 percent of enrollees under the age of 65.
As percentage of enrollees, those younger than 65 were nearly 3 times more likely to be prescribed buprenorphine than those older.
That is, those qualifying for Medicare based on disability rather than age were much more likely to be medically provided the common street currency for fentanyl. That fits with results described and made sense of here for that particularly vulnerable population, the title for that recent post –
“DOCTORS DEFY FEDERAL OPIOID CRISIS SAFE PRESCRIBING RULES FOR HIGH-RISK POPULATION”
and the subtitle –
The vulnerable population of disabled adults unsafely prescribed opioids by licensed medical professionals are 3% of the U.S. population and “account for 25% of opioid-related overdose deaths and hospitalizations”
To summarize graphically,
Driven by pathological levels of the compromised and ethically impaired functioning of America’s professional, expert and servant media classes, Medicare and Medicaid have predictably attained high lethality.
