Today I woke up and turned on the news to hear more about the Opioid Crisis hitting the nation and more specifically NC, where I live. However, rather than hearing that doctors are going to be more cautious in prescribing opioids for every ache and pain someone has, the insurance companies are now denying any prescription greater than a 7 day supply for new users only.
So, my issue with this “fix” to such a large and growing problem is why limit new users of these drugs from a legitimate prescription? Why leave out the existing users from any limitations? And most of all, why is this being done by insurance not legislation or physicians?
I know when I had major shoulder surgery I asked to not being given such a strong painkiller and even told the surgeon’s physician assistant that I already had another pain killer they had prescribed when my shoulder was injured that was more than effective for me. I was told that I might as well fill the prescription, since I might need it. Since I was on my 7th shoulder surgery and had learned many ways to manage the pain through the first six surgeries, I knew icing, heat, compression sleeve and tylenol would be all I would need by day 2 post-operatively. So I need maybe 4-5 pills total of a stronger painkiller.
I wonder how many are like me and anything stronger either makes me itch (thanks to generic drug preservatives), makes me loopy, and then puts me to sleep, so why do I need 30-60 of these pills prescribed? So they can sit in my medicine cabinet until they expire, just in case I ever have that horrible pain again.
How many people could be given a good anti-inflammatory and access to other pain reducing equipment, passive treatments, etc. and not need opioids at all? I’m thinking quite a lot! How many others have only wanted to pay for 5-10 pills but get no discount for that from the almighty insurance company, so go ahead and get the 30-60 pills since it cost the same amount? Why isn’t the insurance system acknowledging their role in putting more pills in future addicts hands by having a failure of a system that encourages over prescribing?
But now to go to the extreme by the insurance company denying coverage for prescriptions that exceed 7 days is just going to make those who truly need an opioid for a legitimate reason have to jump through more insurance red tape/hoops and obstacles to get the care needed.
The system is broken…..fix the root cause not piecemeal together actions that make statements and have little to know true benefit. Those already with prescriptions continue to get them and new folks who want to abuse will work around the 7 day limit.
Tying this back to my point of having 1 doctor who you know and knows you versus who is “in-network” this month, year, or with the new job, insurance provider, someone who knows if you need or just want such medication and knows how much you truly need. Patient control of access to care and physician knowledge of patients and control of what care is appropriate for each individual patient, not what code is best for reimbursement.
My 2 cents on this topic. Please share your thoughts!