Incentivizing change to combat opioid abuse
As the chief legal officers of our states, myself and other attorneys general are taking action on many fronts to fight the opioid epidemic.
We recognize that the devastating cost of addiction demands an unyielding commitment that utilizes every tool at our disposal.
This shared determination drove a broad, bipartisan group of 37 attorneys general, led by my office, to call upon health insurance companies to assess their impact on the crisis, and evaluate and determine appropriate incentives to reduce the use of opioids as a first line therapy option.
Promoting non-opioid therapies, for instance, will help ensure trade groups and major insurance providers do not unintentionally contribute to the opioid epidemic — the preeminent public health crisis of our time.
The facts are clear.
The status quo cannot continue.
Opioid overdoses kill 91 Americans every single day, and more than half of those deaths involve prescription opioids.
Statistics indicate that as many as 2 million Americans are addicted to or otherwise dependent upon prescription opioids. Millions more may be at risk of developing a dependency on these pills.
The staggering abuse of opioid painkillers brings with it financial costs as well, draining the U.S. economy of an estimated $78.5 billion annually. At the state and local level, governments spend nearly $8 billion a year on criminal justice costs related to opioid abuse.
The number of these prescriptions has increased fourfold since 1999 — despite no reported increase in pain.
With the market flooded, it has become easier to obtain prescription opioids. More than 50 percent of people who misuse these medications report they obtained them free from a friend or relative, while another 22 percent abused prescription painkillers obtained directly from a doctor.
These statistics underscore the need for change, and we believe insurance companies can play a major role in turning the tide.
Our coalition of attorneys general is sending letters to insurance companies urging each to review its coverage and payment policies. We hope this starts a dialogue to make sure incentive structures reward the use of non-opioid pain management techniques and does not improperly incentivize opioids, when they are not medically necessary.
Such a discussion is important because medical care providers often favor treatment options that are most likely to be compensated, either by an insurance provider or other means.
While there are certainly situations where opioids represent the appropriate pain remedy, such highly addictive pain pills can no longer be the first choice in treating the majority of aches and pains.
Revised insurance policies can drive much positive change. The companies’ cooperation will play an important role in making it easier for patients to access other forms of pain management such as over-the-counter pain relievers, physical therapy, acupuncture, massage and chiropractic care.
These options are far less dangerous and much more effective for long-term relief.
This strategy will lead to significantly fewer opioid prescriptions, however, insurance companies represent just one aspect of the solution. We must hold all stakeholders accountable and work with every available resource to attack this from a supply, demand and educational perspective.
That’s why my office has partnered with elementary, middle and high schools, along with universities, the faith-based community, trade groups and other government agencies to promote best practices and emphasize the importance of preventing future addiction.
Our attorneys prosecute drug dealers and file lawsuits against all culpable parts of the pharmaceutical supply chain, as evidenced by eight criminal convictions, the shutting down of a pain clinic and $47 million in settlements with 12 drug wholesalers, a record-breaking amount for West Virginia.
These accomplishments and our newest initiative prove that when everyone works together, we can make a major difference in the fight against opioid abuse.
It will not be easy, and the road to change will require every tool at our disposal, but I am confident our efforts will help West Virginia reach her full potential.
Patrick Morrisey is the Attorney General of West Virginia.