My Insurance Company Wants Me Addicted…

By Sean Riley – President & Founder of Safe Call Now

You read that correctly.  After a long run on the road I returned home only to be notified by my insurance company that my doctor’s and surgeon’s request for a particular anesthesia medication had been “denied” for an upcoming surgery that is required because of my past history of drug addiction.  The reason for this request is that this particular medication is non-narcotic and not opiate based which I was addicted to.  Mind you I have been prescribed this medication three times before with absolutely no side effects.  Instead of “jumping the gun” I called my insurance company to get an explanation so I don’t end up again in a booking photo.

A little background which probably won’t surprise many of you that know me…  I tend to get running and moving quite a bit.  For the first time in 15 years I became ill in January of 2018.  Didn’t know what was happening but found out I lost half my blood volume due to a bleeding ulcer.  I was hospitalized, they went in a fixed it, had blood transfusions, no narcotic pain medication and I was on the mend.  In fact my follow-up procedure in May resulted in a “clean bill of health” from my doctor.  I was extremely happy.

Fast forward to August, 2018.  I was in Los Angeles preparing to speak at a very large law enforcement conference and I wasn’t feeling well in my hotel room.  I remembered the symptoms from before so I knew that all I needed was to get a quick blood test and that would tell me what was happening (I know very well now what my blood counts should be as they are always monitored).  Not knowing of any medical facilities in the area I went to the local “Outpatient Doc in a Box” and had a blood draw.  Next thing I knew I was told I was being taken to the hospital via ambulance for emergency surgery on my stomach again.  Screw that I told them, I got places to go, people to see.  Next thing I knew doctors, nurses and security were at my bedside so I knew I was going to lose this fight for the time being and listened to them.

How’s this possible, I can’t go…  I have a speaking engagement I have to be at.  I tried to negotiate with the doctors, I asked them for blood transfusions (I had them the last time) and promised I would be back.  Those negotiations didn’t sit well with them.  Anyways, I had another open bleeding ulcer with an exposed artery this time so they fixed it with four metal clamps in my stomach and a liquid/soft diet until November when they will take them out and maybe I can eat “normal” food again.  So, once I got out of surgery I checked myself out of the hospitals and the doctors and my friends who knew at the time were pretty upset with me but “I had to go” it was time to get to the conference and speak.  Things have gone pretty well, the diet sucks, weight is way down but here’s the kicker!!!

On this next surgery to remove the clamps they denied me the non-narcotic anesthesia and instead are going to give me opiate based medication along with benzodiazipines for the surgery.  I almost fell over in my chair.  How can you put me on the drug I was addicted to I asked?  Their response was that I have 13 years of sobriety and they feel its “safe” enough.  Really?  Where does the medical profession research dictate that this is a healthy option?  This is the craziest thing I have ever heard of and my doctors and the surgeon agree.  They know my addiction history and monitor it closely as well as Safe Call Now Board President Dr. Marc Gonzalez Pharm.D who monitors every aspect of any medication given to me.  Why so much monitoring you may ask?  Accountability, because I am a drug addict and I know it.  I need advocates like them to keep me safe.

Just because I have 13 years of sobriety, my body and brain don’t “reset” and I can take these medications like other normal human beings.  No I will pick up right back where I left off, 30-40 pills a day because that’s what I do.  I told the insurance company that you’re basically going to give me a “death sentence” if you give me these drugs and I will end up again in another booking photo like the one above.  I asked the insurance company if my request was unreasonable and they said it was not but they have to follow guidelines.  I said, you mean from a doctor sitting at a desk reviewing my case who has never seen me, met me and reading my very well documented history of substance abuse and addiction and he still wants to give the same medication that I almost let kill me last time?

So the battle begins… in addiction I fought to get drugs and in sobriety I’m fighting people not to give me drugs in this crazy healthcare system.  Never thought I would have to do this.  In today’s world with all of the negative ramifications associated with narcotic pain medication, I thought the doctors and insurance companies would be more than happy to oblige because if you give them to me, I will be out “running and gunning” trying to get more medication and I will cost you millions of dollars.  I guess they just don’t care.  I’m very fortunate to have many advocates in my corner to help me with this matter and we will prevail.  I’m also pretty much an “asshole” when advocating for the health and wellness of others and myself in the healthcare system, because I just don’t care about them.  Standby as we get ready to open up the can of “whoop ass.”

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