As reported in Risk & Insurance, a new study finds more than two-thirds of treating physicians surveyed say their patients’ expectations impact their decisions on opioid prescribing. The vast majority incorrectly believe morphine and oxycodone are the most effective ways to treat pain. And, 88% say they find it difficult to refer patients to treatment for abuse of opioids.
Like much in healthcare there is something important, lucrative and perverse that often gets overlooked in the story. This applies to the prescription and addiction to opioids too.
The same doctor that prescribes the opioid that his patient gets addicted too then can make his best money on the mandatory drug/toxicology testing he performs every month. And if he gets skiddish about the higher dosages needed to feed the addiction there are many doctors willing to pick up this lucrative business. Think again if you think this isn’t a common business model. It IS the preferred business model today.
But it gets worse, much worse unfortunately. When the need for more opioid and drug testing becomes unaffordable (typically $4,000 to $10,000 per year) otherwise reasonable people feel forced to resort to selling some of their prescribed opioids on the street to help pay for it. Way too often these people can only afford the street version of their opioid. This is called heroin.
Here’s how Redirect Health nips this pervasive problem in the bud:
1. Never call these highly addictive prescriptions "opioids" or "pain killers." Instead, call them "heroin-derivatives." This is what they are. Far fewer people want to start taking these highly addictive drugs in the first place when they know that they are a form of heroin. And, our providers don't like prescribing them when they are called this. 2. Make it easy and affordable ($0 copays) for customers to see a chiropractor and a PCP working together, and help them with practical and customized virtual rehab programs they can easily do at home for free, so they don't have to miss work.
Common sense, but not commonly done.