The opioid epidemic is a multifaceted problem. One of the things that is driving the problem is our culture. We are being told by the TV that if anything is wrong with first even if it’s just for a half a second, we need to take something in order to fix that problem. There’s a pill or ice syrup that can cure whatever it it is that his ailing us. Of course, this is untrue. I have digressed. As a trauma surgeon, I see all types of patients that have all types of physical pain. I’ve seen patient with multiple rib fractures who refuse to take anything stronger than Tylenol. I’ve seen other patients that are crying out in pain in spite of receiving high doses of morphine. In some cases, patients need a combination of short acting and long-acting narcotics. Interestingly, insurance companies are usually more than willing to pay for short acting narcotics but not the safer, less addicting long-acting narcotics.

From NYT:

At a time when the United States is in the grip of an opioid epidemic, many insurers are limiting access to pain medications that carry a lower risk of addiction or dependence, even as they provide comparatively easy access to generic opioid medications.

The reason, experts say: Opioid drugs are generally cheap while safer alternatives are often more expensive.

Drugmakers, pharmaceutical distributors, pharmacies and doctors have come under intense scrutiny in recent years, but the role that insurers — and the pharmacy benefit managers that run their drug plans — have played in the opioid crisis has received less attention. That may be changing, however. The New York State attorney general’s office sent letters last week to the three largest pharmacy benefit managers — CVS Caremark, Express Scripts and OptumRx — asking how they were addressing the crisis. (more…)