Dec. 1, 2018 – Finances: Insurance companies created financial incentives in the 1980s and 1990s to abandon multidisciplinary treatment for chronic pain and rewarded medication-only care. Insurance companies will likely reimburse ED buprenorphine but not the long-term medical and social care that sustain sobriety.
Ease: Withdrawal medications (comfort packs) are complex, potentially dangerous, and a challenge to administer and prescribe. It’s much easier to use buprenorphine to treat-and-street opiate use disorder patients.
Legislation: Politicians often practice medicine through laws that restrict or compel elements of practice. Given the outcry about the opioid crisis, some legislators will support almost any solution. Influential groups that misapply research will lobby for legislators to compel EPs to provide buprenorphine.
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