#OurPain: How money factors into the opioid debate

LAS VEGAS - Tens of millions of Americans depend on opioid medications to ease their chronic pain.

Pain doctors say they'd like to wean their patients off of opioids when feasible, but many of the alternative treatments are not covered by public or private insurance programs.

In the continuing series, "The Other side of Opioids," we explore the role of money in the evolution of this issue.

When retired pilot John Lear's erroneous drug screening came back dirty, he was cut off from his pain medications but was also booted out of his medical plan. He was in agony for months.

I-Team Reporter George Knapp: "Did you think you were going to die?"

John Lear: "Yeah, honestly, I was pretty close to killing myself because I just didn't think I could handle it. I had a gun right here, ready to go, my .45."

Lear suspects the medical provider wanted him gone because his long-term injuries were expensive to treat.

"I've run up a fantastic medical bill, probably quarter million dollars," he said. "They probably said we've got to get rid of John Lear and don't care how we do it. He's costing us too much money."

Everywhere you look in the opioid debate, money plays a key role. Some of the same pharmacy chains which cashed in on opioid sales during the pill mill era now require pain patients to obtain two non-opioid prescriptions for every pain medication they receive. Doctors often require patients to undergo expensive nerve block injections, whether they work or not.

I-Team Reporter George Knapp: "If you don't have this other procedure, which may or may not work, you're cut off?"

Nicole Ball, chronic pain patient: "It's not going to work, and yes I will be cut off from my medication, so I will figure out how to pay for it."

I-Team Reporter George Knapp:  "How do you know it won't work?"

Nicole Ball, chronic pain patient: "I've had it done many times, many times."

"They don't want to pay for medicine period," said Dr. Maurice Gregory. "So, this is what they do."

As a family physician Dr. Gregory makes house calls to help chronic pain patients who have trouble getting around.

He says chronic pain patients often have expensive underlying conditions, the kind that insurers don't want to cover. Across the board, private insurance giants are cutting back coverage for pain patients. Some end up leaving their doctors or turn to street drugs. Many give up.

"It's almost unbelievable, the number of people whose lives have been destroyed, the number of people planning suicides, the number of people who tell me they don't want to live," said Dr. Lynn Webster. "The one entity that hasn't been called out enough that is hugely responsible for the current opioid problem, responsible for the lack of treatment for chronic pain, are the insurance companies."

Example, Dr. Gregory recommends an integrated range of alternative to opioids -- including physical therapy and acupuncture -- but they're not covered by private or government insurance.

Pain expert Dr. Michael Schatman says the U.S. had more than 1,000 interdisciplinary pain programs covered by insurance back in 1999. Today?

"Now outside of the VA and military, we are under 70 of these programs because insurance stopped paying for them," he said.

"Unfortunately, the health care system was changed under Obamacare," said Dr. Forest Tennant.

A pioneer pain management doctor, he thinks the opioid crisis is entirely about money.

"This is a deal to shift money. It's not a deal to save money. Opioids are a very inexpensive way to help people who are truly ill to have a life, keep their health up, live longer, take care of their families and jobs. This is a farce," he said.

Friday night at 6, a look at how the Veterans Administration handles opioid issues on behalf of injured vets.


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