Bad Medicine: TriCare’s noncoverage of evidence-based opiate maintenance therapy

The military’s huge TRICARE insurance program should cover methadone and buprenorphine maintenance therapies for prescription painkiller misuse.

(This is cross-posted at the Century Foundation’s Taking Note)

Sunday’s New York Times included heart-wrenching accounts of newborn babies enduring opiate drug withdrawal. The story provided only one cause for optimism: Both babies and their painkiller-dependent mothers can benefit dramatically from long-term maintenance treatment on medications such as methadone or buprenorphine.

Unless, of course, these mothers were among the ten million active-duty or retired military personnel or dependents insured through the Department of Defense’s TRICARE insurance program. TRICARE limits methadone and buprenorphine prescriptions to short-term detoxification. Echoing the anti-methadone attitudes of the 1970s, TRICARE regulations baldly state, “Drug maintenance programs when one addictive drug is substituted for another on a maintenance basis (such as methadone substituting for heroin) are not covered.”

This is a huge mistake, especially given the military’s escalating problems of prescription painkiller misuse. Keith Humphreys and I say more, in today’s American Prospect.

Author: Harold Pollack

Harold Pollack is Helen Ross Professor of Social Service Administration at the University of Chicago. He has served on three expert committees of the National Academies of Science. His recent research appears in such journals as Addiction, Journal of the American Medical Association, and American Journal of Public Health. He writes regularly on HIV prevention, crime and drug policy, health reform, and disability policy for American Prospect,, and other news outlets. His essay, "Lessons from an Emergency Room Nightmare" was selected for the collection The Best American Medical Writing, 2009. He recently participated, with zero critical acclaim, in the University of Chicago's annual Latke-Hamentaschen debate.