Let Us Help
Imagine throwing a life preserver on a rope out to a drowning man in the ocean.
Opioid dependence is a life threatening condition. Imagine throwing a life preserver to a drowning man. He has no hope other than to grab on and not let go. You are going to have to pull the rope to help get him to safety. While it seems natural to do everything possible to save a drowning man, the responsibility can be scary. What if you can’t hold on long enough? What if the man lets go and doesn’t make it? Will you feel responsible? Will other people blame you for the man not making it to safety?
What would you do?
When you throw out the life preserver to the drowning man, do you require that he first state his honest desire to live? Do you ask him to wait while you order just the right size life preserver? Do you stop along the way in pulling him in to verify his grip as he freezes in the water? If you are standing by while someone else holds the rope, do you question his or her qualifications to pull in a drowning man? They have two hands holding a rope and a willingness to pull and you want to question their competency? Why not grab the rope and help pull instead?
In that sort of dramatic situation, I think anyone would hold on to the rope and do their best without thinking about it at the time. In our daily lives, there may be situations that are not so dramatic where we can do our part to save a life. When we have to make these decisions, we may second guess ourselves. We might worry and wonder if we are doing the right thing. Is it better to not get involved? Should we do everything possible to protect ourselves?
For doctors, pharmacists and decision makers at insurance companies, we have an opportunity to save lives.
In 2002, the first medication was approved by the FDA for the treatment of opioid dependence. This medication is Suboxone. We now have additional brands of buprenorphine containing medications available. So, people who are addicted to heroin or pain pills now have a new tool to help them to quit these deadly drugs. In addition to medication, therapy is also recommended.
There is an epidemic of opioid dependence related overdose death.
People are taking too many pain pills. They are buying heroin on the street without knowing the potency. A set of tools has been given to us in the healthcare profession to save those people in danger who ask for help.
I have had patients bring a prescription for suboxone to a pharmacy only to be told that it will take nearly a week to order it. Then the pharmacy holds onto the prescription. When a person addicted to opioids wants to quit drugs, there may be a narrow window of opportunity to help. If that person starts to get sick and starts to crave opioids again, they may relapse before having the chance to start treatment.
Pharmacists, please help us.
Pharmacists, if you cannot help a patient who is trying to fill a legitimate prescription for a buprenorphine based medication such as Suboxone, Subutex or Zubsolv, please consider giving back the prescription without writing or stamping all over it. If you aren’t sure what you should do, call the doctor who wrote the prescription first and have a conversation. If you cannot help, let the patient find a pharmacist who can help.
Insurance companies, please help us.
Insurance companies, I don’t know what to say. You want prior authorization for every single patient. Fine, we, the doctors, will play along and fill out the online form. More often now, I am seeing insurance companies looking for any possible reason to deny and delay coverage for these life saving medications. Why? Who are you protecting? Certainly not the patient.
I have seen insurance companies deny coverage for buprenorphine medications, including Suboxone, Subutex and Zubsolv as well as generic equivalents. They sometimes deny based on missing information. Often the information they say is missing was submitted already.
I have had to get on the phone with impersonal insurance pharmacy program representatives and point out that the drug test results, the PDMP review statement, the statement about the patient having a true diagnosis of opioid dependence, the statement that the patient is compliant with therapy are all there in the documentation submitted. Seriously? A patient sometimes cannot get their first prescription filled. Insurance companies, please help us by doing your part to save lives.
Buprenorphine medications for opioid dependence are too expensive.
To the pharmaceutical industry, we need lower cost alternatives. Even the generics are too expensive. The cost for the brand name medications for opioid dependence is way too high. Patients need better access to these medications. Thank you Orexo for providing free vouchers to at least help patients get started.
Medication Assisted Treatment is readily available in our region.
Fortunately, in the area where I work, there are many doctors willing to get credentialed to prescribe buprenorphine medications for opioid dependence and addiction. I have heard some patients complain about doctors who make it difficult to get help. Please, treat these patients with respect. They are asking for your help. It is not easy to ask for help. Please do what you can to provide treatment or refer them to someone who is able and willing to help. Opioid dependence and addiction do not make a person bad. It is not a moral failing. It is a medical condition that requires treatment.
If you are a patient who is seeking help for opioid dependence and addiction, you have a right to get treatment. You don’t have to continue suffering. Help is available. There are online resources to help you find a doctor near you who is able to prescribe medication and refer you for therapy that will help you quit drugs now. If you are in the Fort Lauderdale or Broward County area, you can call me, Mark Leeds, D.O., Osteopathic Physician, at 954-776-6226.