Local Pain Doctors Say Insurance Is Hindering Opioid Addiction Recovery

The state's crackdown on pain management doctors has created high hopes of helping curb the opioid epidemic.

With new limitations on what those doctors can prescribe, clinics now are seeking alternatives to treat addiction. Sometimes that is easier said than done.

Patients say drugs containing Buprenorphine work wonders. The problem is getting insurance to cover the treatment.

A little piece of film inside your mouth halts withdrawals, relieves pain and anxiety and does not target the reward center of the brain. Buprenorphine comes in different doses under different brand names, including Suboxone, Bunavail and Zubsolve, but Dr. James Lynch says all of them work about the same.

“You can take 50 times the amount,” he said. “You can’t overdose, so there’s your safety.”

Even if a patient tried to inject the medicine, built-in Naloxone counteracts the high.

Jordan Williams was addicted to opioids, and eventually heroin, for years. One night she ran out of money and drugs. Entering withdrawal, she went to steal money from her dad, but got caught. In that moment, she was forced to ask for help, and the only clinic that would accept her was Suboxone Solutions on N MacArthur Blvd.

“Now looking back, that was God working in my life,” she said, “like, hey, you can’t do it on your own. Here you go.”

That was in 2013. Williams took Suboxone for a year and a half before tapering off. Now she is sober and living a successful life as a nurse.

She said, “I don’t know where my life would be or where I would be if this office wouldn’t have answered and told me that I could come in that day. Literally they saved my life that day.”

But Dr. Lynch says insurance companies have not been easy to work with when he is trying to prescribe Buprenorphine drugs.

“I get letters back from the insurance company. ‘No, they must fail Percocet and Fentanyl first.’ I get these letters over and over, five times a week.”

Out of pocket, the cheapest you can find these drugs is about $60 for a 60-day supply.

Dr. Lynch believes in the fight to overcome the addiction epidemic, changes have to be made in the insurance industry as well.

If you or a loved one are battling opioid addiction, find more information about resources here.

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