Don’t Be Too Quick to Blame Doctors for the Opioid Crisis

Physicians, including urgent care providers, may be taking more than their share of the blame for the ongoing opioid crisis in the U.S., according to a report by The New York Times and ProPublica. While some public officials and media outlets have accused doctors of, essentially, enabling opioid addiction by prescribing narcotic pain medications too liberally, data show that prices set by insurers may be steering doctors and patients alike away from less-addictive alternatives. Opioid are just plain cheaper and easier to get in many cases, making it all that much harder to advocate against their use. Now the state attorney general in New York has sent a letter to CVS Caremark, Express Scripts, and OptumRx asking them to explain what steps they are taking to help fight opioid addiction. For their report, the Times and ProPublica looked at the prescription drug plans of 35.7 million Medicare members. Most covered common—and highly addictive—opioids without prior approval. A patch containing buprenorphine, a less addictive opioid agent, was both more expensive to obtain and did require preapproval. Insurers were also criticized by sources quoted in the report for making it too difficult for addicts to get treatment, with the former head of the CDC noting that opioids are easier to get than treatment for addiction. The U.S. Department of Health and Human Services is doing its own research into whether insurers really do make opioids more accessible than other, less addictive pain treatments. (JUCM will offer a look at the role urgent care can play in addressing the opioid crisis in our November issue. Stay tuned.)