By Ed Coghlan

The New York Times reported Friday that opioid prescriptions have been dropping for the first time since OxyContin was introduced in 1996.

One of the nation’s largest insurers announced this week it will slash its customers’ use of potentially addictive opioid pain medications by 25% over the next three years. The 25% reduction target would bring Cigna plan holders’ use of the drugs back to the “pre-crisis” levels of 2006, according to the company.

For chronic pain patient advocates, this announcement represented another example of what they believe is the troubling trend of shrinking the supply of pain medication to patients who use them responsibly.

“Addressing the addiction issue is an important goal. What’s missing is what the company proposes to do to promote alternative therapies that will help chronic pain patients who are using these medications responsibly,” said Paul Gileno, Founder and CEO of the U.S. Pain Foundation.

Cigna’s chief medical officer for Cigna’s behavioral health business is Dr. Doug Nemecek, who gave the National Pain Report the following statement:

“We recognize that for millions of people, access to opioids for pain relief is essential; for example, people undergoing treatment for cancer or receiving palliative care. However, for millions of others, a prescription for opioids – especially a high dose for more than 21 days – should be the last resort, not the first. Our policy is consistent with the Centers for Disease Control and Prevention’s guidelines and aims to break the cycle of dependence, overdose and death. We want to encourage doctors to prescribe opioids responsibly, treat pain appropriately, and help people with substance use disorders get the treatment they need so they can have healthy, productive lives.”

Cigna believes the reduction can be achieved by:

• Providing physicians with profiles on how their prescribing habits compare with the CDC guidelines as well as compare their prescribing habits with other doctors in their communities to see if they are doing something different from their fellow prescribers.
• Helping physicians understand when their patients are receiving hazardous levels of opioids and other drugs by conducting outreach to more than 2,600 prescribers of high dosages of opioid medications identified through Cigna’s risk detection outreach project.
• Supporting the White House and Congress efforts to increase patient limits for qualified physicians who prescribe buprenorphine; making med-assisted therapy more accessible.
• Calling for a change in the lexicon for how we talk about substance use disorders, removing words like “abuse” from the conversation.