Insurers have been making medications for treating opioid addiction more expensive and harder to access, even as more and more Americans suffer and die, a new study suggests.
The most effective way to treat opioid addiction is with so-called medication-assisted treatment (MAT), which addiction specialists widely use and recommend.
In recent years, the drug has been more widely accepted by doctors and policy-makers as it becomes a clear and crucial clear to combating the opioid epidemic.
Yet, since 2007, insurers have been creating increasingly strict rules around the prescription of the medication, making it difficult - if not impossible - for patients in dire need to access, a new Oregon science and Health University study found.
While prescription opioids like OxyContin are covered by almost all insurers, now just 35 percent covered medication to treat addiction without restrictions in 2018, a new study found
About 130 Americans die of opioid overdoses every day.
While harm reduction efforts - like handing out clean needles and naloxone - are helping to save lives from HIV infections transmitted through shared needles and by reversing overdoses, these are not necessarily long-term solutions.
Quitting powerful, addictive heroin, fentanyl or prescription opioids brings on intense withdrawals.
The symptoms - nausea, vomiting, intense anxiety, insomnia, excruciating body aches, tremors and sweating - can become very severe, but aren't life-threatening.
Nonetheless, the nightmarish process pushes many to seek relief by relapsing and taking opioid drugs again.
Although it is not itself addicting, buprenorphine acts on opioid receptors in the central nervous system, quelling the symptoms of withdrawal without providing a high.
Still, its chemical similarities have made some wary of the drug, and want to keep it closely controlled.
Under the auspice of this concern that the drug could be abused, or that doctors are prescribing unnecessary, expensive drugs, insurance companies may require pior authorization for certain prescriptions.
This means that the even after a doctors has prescribed a drug, like buprenorphine, a patient has to wait to fill it until the insurer has agreed that it's necessary.
That waiting period varies in length depending on the drug and the insurance company.
Blue Cross Blue Shield, for example, says that its waiting period is about 24 hours for an urgent request, or as long as 15 days for a standard one.
Withdrawal from heroin can start with in six to 12 hours of the last time someone used the drug.
So no matter if a doctor puts in an urgent or standard request, that's plenty of time for withdrawals to begin, potentially driving someone to use opioids again.
'Prior authorization policies are commonly used to control costs or manage pharmacy utilization,' said lead study author Daniel Hartung, an Oregon Health and Science professor of pharmacy.
'However they can also disrupt or delay treatment for individuals who are vulnerable to relapse.'
Furthermore,'the reasons for restrictions on buprenorphine might reflect inaccurate perceptions of drug risk, societal norms related to the stigma of addiction, or financial considerations, the authors wrote.
About 15 percent of Americans are insured by the publicly subsidized Medicare, which doesn't cover the alteernative MAT drug, methadone.
Now, fewer insurers are offering unrestricted buprenorphine, too.
In 2007, 89 percent of insurance companies covered the drug without delays, according to the new Oregon Health and Science study.
Now, just 35 percent cover it.
The prescription opioids responsible for the genesis of 75 percent of addictions, on the other hand, are covered by between 93 and 100 percent of insurers - without restrictions.
Oregon passed a law in September making it illegal for addiction treatment doctors from refusing to prescribe MAT, but much of the country as not followed suit.
'Many people still believe that medication treatment isn't really recovery,' Korthuis said.
'Overwhelming scientific evidence supports that medicines like buprenorphine are far more successful and safer than abstinence-only approaches.
Buprenorphine saves lives. Abstinence-based approaches don't.'