In the Face of Rising Overdose Deaths, Do We Need to Change the Way We Treat Addiction?

Jan 30, 2015

New numbers released by the federal government reveal a continuing upward trend in drug overdose deaths, with 43,982 deaths in 2013 from both prescription medications and illegal drugs combined. Deaths involving prescription opioids increased 1 percent from 2012, while heroin-related deaths rose a staggering 39 percent.  However, almost twice as many people died from prescription opioid overdoses (16,235) as from heroin (8,257).

The CDC has called prescription drug abuse an epidemic. Dr. Andrew Chambers, M.D., addiction psychiatrist at the Indiana University School of Medicine says the growing crisis draws attention to the need to focus more healthcare dollars on treating long-term addiction.

Chambers says that currently the health insurance system is not set up to support addicts in overcoming their addictions. For example, there is a discrepancy in the coverage of methadone, a medication prescribed both to treat pain and to overcome addiction to opioids like oxycodone and heroin. According to Chambers, most health insurance plans will readily cover methadone if prescribed to treat pain, but not if it’s prescribed for addiction.

He says the problem extends to other addictions, as well. For example varenicline (marketed as Chantix), a drug that has been shown to be highly effective for overcoming nicotine addiction when used long-term, is only covered by insurance for up to three months in Indiana, the state where he practices.

Chambers believes more of his patients would be able to conquer their addictions if they could afford the treatment, and this would reduce the likelihood of severe and costly health consequences of the addiction. Even more puzzling is the fact that health insurance companies seem to have no qualms about covering the cost of these consequences, which are usually much higher than treating the addiction itself.

“I have a patient who is undergoing a $10,000 work-up for the possibility of lung cancer due to smoking,” Chambers told Sound Medicine. “And while insurance was covering that work-up, involving radiology and highly-paid specialists, they at the same time weren't willing to cover the treatment of nicotine addiction under my care as an addiction psychiatrist."

Dr. Andrew Chambers is Associate Professor of Psychiatry and directs the Addiction Fellowship Program at Indiana University School of Medicine in Indianapolis.