Risk factors which exclude large number of pain patients from getting treatment


Dr. Stephen Hull, director of Mercy Hospital’s Pain Center, said insurance company policies to reduce over-prescribing will be helpful, but more needs to be done to lower America’s reliance on opioids to control pain. There are no long-term studies that prove the effectiveness of opioids in controlling chronic pain, scientists say…

Anthem also will warn doctors when they see a patient seeking painkillers from an emergency department and will investigate doctors who are prescribing high doses of opioids, she said. Harrell said another program set to start this fall will notify doctors if a patient has previously been in a substance abuse treatment program or overdosed and gone to an emergency department, all warning signs that a patient may try to doctor shop…

Mark Slitt, a Cigna spokesman, said the insurance company launched a program a decade ago to identify over-prescribing, and has been adding to it ever since.

“The opioid crisis is a national tragedy. Cigna’s goal is to work collaboratively with doctors, as well as organizations like (the American Society for Addiction Medicine) to help find ways to fix the problem. Contacting doctors proactively regarding their patients’ risk factors is just one part of this effort,” Slitt said…



First of all, if opiates are to be used for chronic noncancer pain, physicians need to assess the patient for risk factors, which include a history of smoking, family or personal history of substance abuse, history of sexual abuse, and a history of psychological disease…


Risk Factors for aberrant behavior

• Lifetime history of substance use disorder (alcohol, tobacco, illicit substances)
• Psychiatric co-morbidity
• History of pre-adolescent sexual abuse
• Family history of substance abuse
• History of legal problems
• Younger age (16 – 45)
• Increased functional impairment