Some insurers thwart efforts to use medication treatment for addiction

Krista Sizemore's brain was crying out for heroin.  But she knew she was pregnant. She knew her baby needed her to stay safe. She knew what could happen if she used again. She thought she'd been through it all, even overdosing once in her father's home. Sizemore, 26, called her mother, Kimberly Wright. "I knew I wasn't going to stop without help," Sizemore said. But when Sizemore tried to get help from a top addiction doctor in Northern Kentucky, the insurance blocked the first attempt. WellCare of Kentucky gave her a little Suboxone but required Zubsolv, a similar medication used to reduce cravings and stabilize heroin users.Then, on Labor Day weekend, Sizemore tried to get her second prescription filled. Again: Denied. The insurance company wanted a new prior-authorization form, just a month after the first. Sizemore is not alone in struggling with insurance. During a nationwide epidemic in which one American dies every 19 minutes from opioid or heroin overdose, addiction doctors say insurance barriers to medication that can save lives are instead putting them at risk for death.