Cigna Plans To Cut Customers' Opiate Use By 25% Over Three Years

By Zachary Siegel 06/09/16

Cigna's plan to combat the opiate crisis also focuses on treating addiction as a chronic disease and eliminating the stigma surrounding addiction.

Cigna Plans To Cut Customers' Opiate Use By 25% Over Three Years

Cigna—soon to be the largest health insurance company in the United States—recently announced that it's taking direct action in order to mitigate the current opiate crisis. 

Cigna’s plan addresses several different parts of the opiate epidemic—but mainly how substance use disorders are treated, particularly when they involve opiates. A major part of Cigna's plan is to reduce "its customers’ opioid use by 25% – which would return to 2006 levels, before the drug crisis," according to a May company release. 

To achieve this goal, Cigna will work with physicians to educate them on prescribing guidelines and improve access to medication-assisted treatment (or maintenance therapy), Cigna's Chief Medical Officer for Behavioral Health, Dr. Douglas Nemecek, told Reuters.

The only treatments shown to reduce mortality by 50% or more is the use of Suboxone or methadone, two medications that the vast majority of treatment centers in America shun, according to a British study of 151,983 adults treated for opioid dependence between 2005 and 2009. Perhaps in throwing its weight behind these medications while refusing to cover only psychological support, Cigna will help expand their use (which remains heavily stigmatized).

The announcement made by the health insurance giant brought to light other major flaws in the treatment of opiate addiction. "Unlike what we see in other chronic conditions, such as diabetes and cardiovascular disease, there currently exists no road map of evidence-based best practices for physicians to follow to effectively and efficiently treat substance use disorders like opioid addiction," Nemecek told Business Insider.

Which is why patients are sometimes told to spend thousands of dollars to pet horses, live by the beach, and pay for unnecessarily posh amenities that effectively do nothing to address addiction. 

Another part of Cigna’s plan—aimed at cutting customers’ consumption of prescription opioid pain relievers like OxyContin and Vicodin by 25% over the next three years—poses problems. The Fix recently reported that the number of prescriptions written for painkillers has been declining since 2012, yet the number of overdoses continues to rise. This makes sense, given the data indicate the vast majority of people who overdose on prescription painkillers obtained them not through doctors, but bought them illegally from dealers and friends. Simply reducing the number of prescriptions hasn’t shown to work yet. 

This reduction may also leave patients who are in chronic pain vulnerable to losing their prescription. Cigna must roll back prescriptions judiciously, so as not to harm those who are in legitimate need of long-term opioid treatment. 

Now that the opiate crisis has America’s attention, it’s high time to revamp how addiction is treated. It looks like that just might happen. 

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Zachary Siegel is a freelance journalist specializing in science, health and drug policy. His reporting has also appeared in Slate, The Daily Beast, Salon, Huffington Post, among others. He writes often about addiction, sometimes drawing from his own experience. You can find out more about Zachary on Linkedin or follow him on Twitter.