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What Role Do Insurance Companies Play in the Opioid Crisis? It Might Not Be What You Expect

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Do the insurance companies feed the opioid crisis to make more money? The blame for the opioid crisis is often placed on doctors and Big Pharma. But another big suspect might have gotten away too easily: insurance companies. Many chronic pain sufferers rely on opiates to improve their quality of life. But there are many safer alternative opioid use disorder treatments that insurance companies do not want you to hear about. Illicit drugs kill more people than prescribed opiates. However, there are many chronic pain sufferers who experience addiction and overdose too. High-risk opioids are covered. Safe medications, on the other hand, are not. A 2012 national survey found that over 2 million Americans suffer from opiate addiction related to prescription painkillers.

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How Insurance Companies Respond to the Opioid Crisis

In the middle of an opioid crisis, insurance companies make it even harder for those who need strong painkillers to access medication with a low addiction risk. Generic, high-risk opioids are inexpensive compared to their safer counterparts. Insurance companies are more interested in increasing their profits than helping their members. Most chronic pain sufferers find it hard to gain access to non-addictive medicine. Their insurance plans do not cover them. Out of pocket expenses are often too much to bear too. This situation forces many chronic pain sufferers to turn to generic opioids. Insurance companies do cover generic opioids and make them available without prior approval. This might sound counterproductive, but it does not end here. Only one-third of 35 million people covered by Medicare have access to Butrans, a painkiller skin-patch that contains a less risky opioid. You can find Lyrica and Lidocaine patches on the list of drugs that aren’t covered despite being safe. The latter doesn’t have any risks of addiction. But its cost makes it impossible to buy without coverage.

Deceitful Marketing Techniques Used by Insurance Companies

Have you ever heard of Hillbilly heroin, otherwise known as kicker? This is the street name of a prescription opiate advertised as having a risk of addiction under 1%. Purdue Pharma used deceiving marketing techniques to put a high-risk opiate on the market in the 90’s. The company misled doctors who had no idea how potent the narcotic they were prescribing was. In reality, chewing the tablet, snorting the powder or injecting it leads to a high as powerful as the one created by heroin. Poorly trained doctors used Oxycontin as painkiller even for milder cases. This lead to the drug being easily purchases by dealers too. Also, Oxycontin has a high risk of overdose, especially when taken as powder or injected. Oxycontin is also among the drugs you should never mix with alcohol. The real danger is the fact that opiates quickly build up a tolerance. Inevitably, chronic pain sufferers will need a higher dose. Purdue Pharma faced many lawsuits and finally pleaded guilty in 2007. But the story doesn’t quite end there.

Oxycontin Is Still on a Market

Not only is a drug with a high-risk of addiction on the market but it is also easy to reach. Plus, it is covered by health insurance companies like The United Health Group. Many chronic pain suffers have no choice but to get dangerous drugs like Oxycontin. They cannot afford safer ones. But Oxycontin is not the only drug considered high risk. Vicodin, Lorcet, Lortab, Duragesic and Methadone are among the few commonly used drugs for pain management. Worse, opiates like Oxycontin build up a tolerance. After a while, you will be forced to increase the dose if you want to get the same effects. On top of that, one of the long-term effects of Oxycontin is the fact that it affects our natural opiates. Our body creates a small amount of opiates when we get hurt. But when we supplement opiates our bodies are no longer stimulated enough to produce them. Sadly, this can lead to even more pain since our bodies become incapable of managing pain on their own. This reaction makes chronic pain sufferers become even more dependent on their painkillers. When switching medication to a low-risk painkiller, patients suffer strong withdrawals. Without proper treatment the transition is almost impossible to make.

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Alternatives Treatments Are Ignored by Insurance Companies

Alternative treatments like therapy and acupuncture are expensive. Their effectiveness is often questioned too. Additionally, these treatments are more complicated for patients to follow. The classic pain management treatment requires taking a pill. Alternative treatments are more of a time investment. Many chronic pain patients feel uncomfortable speaking with a therapist about their struggles. Others have religious beliefs that go against practices like acupuncture. That said, while the interest in alternative treatments is growing, insurance companies are not keeping up. Morphine is also a strong opiate that requires close monitoring due to high risk of addiction and overdose. For many chronic pain sufferers who can’t afford safer treatments, it is the only choice they have. In the end, insurance companies ask their members who use drugs that make them feel euphoric if they want to try something else. Also, if you want to try Suboxone as part of an opiate replacement therapy, you might run into another surprise. The treatment is only covered by Medicaid if you live below the 133 percent of the federal poverty level. Insurance companies only make it harder for people suffering from addictions to get treatment. For them, it means more money spent.

New Ways to Treat Pain

Members of the medical community are looking for answers through alternative therapies. The way we perceive pain and how we cope with it is a plays an important role in pain management. There are many new therapies that can help patients on every level gain more effective coping mechanisms. Cognitive behavioral therapy, osteopathic manipulation, acupuncture and yoga are just a few alternatives to opiates. The main problem with these therapies is, again, linked to limited financial resources. People suffering from chronic pain would have to pay out of pocket for them. Only physical therapy is covered and recognized as effective. But its coverage varies from one state to another. These therapies also receive some critics when it comes to effectiveness. For now, only acupuncture and cognitive behavioral therapy are proven to help chronic pain suffers. However, meditation techniques also show potential when it comes to the way we perceive pain. A study performed by Mayo clinic in 2008 found that alternative treatments are more effective for pain management. This applies to patients who deal with opiate withdrawal too. The alternative therapies, while they take more time and are more expensive, are the only ones that do not involve any long-term risks. Skeptics discuss the placebo effect, especially when it comes to therapies with a spiritual dimension such as acupuncture and yoga. While the mechanisms behind Yoga and acupuncture are not fully understood, what is important is that they works and are safe.

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The Role of Insurance Companies in the Opioid Crisis

It is true that the large chunk of the overdoses was caused by illicit drug abuse. But the number of addiction cases related to prescribed opiates are on the rise as well. Insurance companies encourage opiates simply because generic opiates are inexpensive. They do so by not covering low-risk therapies and making it harder for their members to have access to them. Drugs like Lidocaine Lyrics are too expensive for most people. Additionally, insurance companies do not want to cover them. As a result, chronic pain suffers have no choice but turn to strong opiates. Alternatives exist and pain can be managed without the risk of addiction. Therapies like CBT, DBT and motivational interviewing fall into the alternative therapies category. Despite having studies that prove their efficiency, insurers are still not convinced. Unfortunately, many chronic pain sufferers are in a catch-22 situation. They cannot afford living a normal life without medication. The real problem lies in the cost of these alternative therapies. Insurance companies will not cover these costs despite the high premiums. Chronic pain sufferers often cannot work. They cannot afford to pay for medication that are not covered by insurance. As a result, they have no choice but to take the generic, inexpensive painkillers. When they do take medication, it often does more harm than good. If you ever took opiates and are not sure whether you suffer from an addiction or not, consider taking the addiction quiz. Also, do not hesitate to contact us if you have any questions or concerns.