Opioid and heroin misuse is a growing epidemic in our country. In 2014, 29,467 people tragically died in the United States because of opioid-related overdoses. In Massachusetts alone, there has been a 63 percent increase in these overdoses since 2012. By learning more about the problem and hearing the stories of those suffering from a substance use disorder, we can work together to stop this crisis.
What are opioids?
Opioids are medications that relieve pain. Medications like Vicodin, OxyContin, Percocet, and morphine are usually prescribed for painful conditions, injuries, and surgical procedures.
What are the consequences of opioid misuse?
Regular opioid use can lead to physical dependence and addiction. Some of the warning signs of opioid use disorder can be missing pills or medication bottles, taking more medication than has been prescribed, abrupt changes in finances, dramatic mood changes, or changes in grades, friends, sleep, or appetite. Opioid use disorder can lead to serious medical complications, brain damage, overdose, and death.
What's the connection between opioids and heroin?
Recent national data suggests that people who suffer from opioid use disorder may be more likely to turn to heroin. Heroin is easily available and less expensive.
What is Drug Take Back Day?
It's a national initiative that aims to provide a safe, convenient, and responsible means of disposing prescription drugs, while also educating the general public about substance use disorder.
What can I do?
The Blue Cross Prescription Pain Medication Safety Program
Opioid misuse is a safety and health care quality issue for our members and our community. That’s why we worked with doctors, pharmacists, and outside experts to create our Prescription Pain Medication Safety Program that has successfully reduced the risk of substance use disorder and other potential health issues related to long-term use of opioids.
We've reduced the risk of opioid misuse and use disorder while protecting vulnerable patients. Over a three-year period we:
Eliminated an estimated 21.5 million doses of opioid-based medications in the community.
Reduced claims for long-acting opioids such as OxyContin by approximately 50 percent by switching patients to short-acting pain treatments.
Stopped 62,000 members from receiving inappropriate levels of acetaminophen.
- Reduced claims for short-acting opioid painkillers such as Vicodin and Percocet by approximately 25 percent.
- Provided members who receive large amounts of narcotic medications with access to pain management experts and non-narcotic methods of pain control.
- Improved care coordination for members with pain-management needs, especially for members with more than one provider-prescribed medication.
How We Did It
The Prescription Pain Medication Safety Program:
- Implements opioid-prescribing best practices that include:
- A treatment plan between doctor and patient that considers non-narcotic treatment options
- A risk assessment for addiction that’s signed by the patient
- An opioid agreement between the doctor and patient
- Choosing a single pharmacy or pharmacy chain to be used for all opioid prescriptions
- A prior authorization requirement for all new short-acting opioids prescriptions for more than 30 days and for all new long-acting opioid prescriptions
- A three-day supply of short-acting opioids if prior authorization isn’t immediately available, allowing time for authorization
- Limiting acetaminophen/opioid combination products to less than 4 grams per day
- Informs doctors about their patients’ narcotic prescriptions so they can identify those who receive opioids from multiple doctors.
- Makes sure that members have access to the care they need. Cancer patients and terminally ill patients are exempt from authorization requirements.
What’s Available to Blue Cross Members
In addition to promoting substance use disorder prevention, we continue to provide our members with behavioral health and substance use disorder treatment options and services, including:
An extensive network that includes approximately 200 health facilities and 10,000 doctors in a number of different behavioral and mental health specialties.
Developed with researchers at Brigham & Women’s Hospital, Life Balance is designed to improve health outcomes for members with behavioral health conditions and significant health conditions.
Integrating medical and behavioral health care.
- A Suboxone Consultation & Outreach program and other medication-assisted therapies to aid and sustain recovery from opiate use disorders. The program is a collaboration of a licensed addictionologist, doctors, pharmacists, social workers, and nurses who help members reduce the potential for relapse.
- REACH (Recovery Education & Access to Community Health): Developed with Beacon Health Strategies, REACH is designed to improve care for members with serious behavioral health conditions or substance use disorders who may have difficulty in traditional care plans.