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Opioid Treatment

Opioid misuse among Americans has become an epidemic. Drug overdoses are now the leading cause of injury death in the United States at nearly 44,000 per year.1 As opioid misuse and addiction continue to rise, we are joining with providers, members, and their communities to treat and overcome the opioid epidemic.

Addressing the opioid epidemic

With opioid addiction and overdose deaths continuing to rise, our health plans continue to combat the opioid epidemic through: 

  • Care management and utilization training and outreach.
  • Working with our providers to address responsible opioid prescribing. 
  • Partnering with local behavioral health managed care organizations and collaborating on information, such as prior authorization requirements for medication-assisted treatment medications. 
  • Urging change in public policy, including promoting training for opioid treatment and developing waivers to allow matching dollars for inpatient behavioral health admits greater than 15 days.
  • Studying pharmacy, professional, and facility data to identify trends and opportunities to intervene with our provider community.

Working with our members

We take extra effort to educate our members about the risks of opioid use. With the help of our providers and through our outreach campaigns, we urge members to:

  • Dispose of unused medicines. Get rid of the medicines that are no longer needed. Keep track of what’s left, and be aware if it goes missing.
  • Learn the risk factors for drug abuse.2 They can include a family history of addiction, a family history of mental health issues, and peer pressure, especially among children.
  • Join our opioid addiction treatment care management programs. With the help of trusted, local provider relationships, our care management programs provide personal, specialized care that destigmatizes addiction and offers physical and mental support. 

More: Opioid Overdose Prevention via the Centers for Disease Control and Prevention (CDC)

Working with our providers

Our providers are in a unique position in this crisis. Not only do they prescribe medications, they also have the opportunity to identify abuse and talk with patients about the hazards of opioid use.

As such, we encourage our providers to:

  • Consider alternative pain treatment options. Opioid drugs should not be the default treatment. Discuss with patients all possible treatment options and their benefits and risks.
  • Advise patients to not leave prescriptions in easy-to-access areas. Seventy-five percent of young people who have abused prescription pain medicines have gotten them from a family member or a friend.3 Urge patients to properly store medications and keep them locked.
  • When opioids are necessary, “start low and go slow.” Prescribe opioids at the lowest effective dosage. 
  • Follow up. Meet with patients again within one to four weeks of prescribing opioids. When treatment is complete, reduce or taper dosages, or discontinue them altogether.

What kinds of drugs are opioids?

Opioids are a class of drugs that includes legally prescribed pain relievers,  synthetic drugs like fentanyl, and illegal drugs like heroin. These drugs interact with opioid receptors in the body and brain.4 When opioid drugs bind to these receptors, they can drive up dopamine levels in the brain's reward areas, producing a state of euphoria and relaxation.5 This feeling of euphoria can lead to misuse and addiction.6

Prescription opioids include painkillers such as:

  • Morphine.
  • Methadone.
  • Buprenorphine.
  • Hydrocodone.
  • Oxycodone.

These painkillers often are referred to under their brand names:

  • OxyContin®. 
  • Percocet®. 
  • Palladone®.
  • Vicodin®. 
  • Percodan®. 
  • Tylox®. 
  • Demerol®.

1. Findings from The Facts Hurt: A State-by-State Injury Prevention Policy Report – Trust for America’s Health and Robert Wood Johnson Foundation at http://healthyamericans.org/reports/injuryprevention15/ and from CDC – Injury Prevention & Control: Opioid Overdose at www.cdc.gov/drugoverdose/.

2. National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services. Commonwealth Prevention Alliance for the PA Stop Opiate Abuse Campaign. *WebMD April 23, 2013 article, “Prescription Drug Abuse Among Teens: Survey.”

3. WebMD April 23, 2013, article, “Prescription Drug Abuse Among Teens: Survey.”

4. https://www.drugabuse.gov/drugs-abuse/opioids#summary-of-the-issue.

5. https://www.drugabuse.gov/publications/drugfacts/fentanyl.

6. https://www.drugabuse.gov/drugs-abuse/opioids#summary-of-the-issue.