Battling the opioid epidemic

Blue Cross Blue Shield of Michigan and Blue Care Network are continuing our efforts to combat the opioid epidemic through an array of initiatives and increased communications about the latest news and research. Check out the following items.

Blue Cross limits opioid pain relievers to 30-day supply; first fills of short-acting opioids to 5 days

Opioid quantities permitted for acute pain often exceed the duration necessary for treatment, leaving unused pills in households that, potentially, could fall into the wrong hands. More than three out of four people who abuse prescription medications obtain them from friends or family.

As part of our effort to decrease accidental overdoses and minimize opioid diversion, Blue Cross is changing how we manage opioids for our commercial members. Starting Feb. 1, 2018:

• All fills of opioid pain relievers will be limited to a 30-day supply.
• Initial fills will be limited to a five-day supply for members who haven’t recently filled a prescription for opioid therapy and have been prescribed a short-acting agent.

The initial fill limits won’t apply to members with oncology diagnoses or in end-of-life care.

Studies show that taking opioids for only a matter of days can lead to unintended long-term use. That’s why it’s important to prescribe the shortest duration of opioids possible. The Centers for Disease Control and Prevention guideline recommends three days or fewer days of opioids for most cases of acute pain.

Health care providers and health plans can work together to ensure appropriate access to pain management and decrease the risk of opioid abuse. We encourage you to use the Michigan Automated Prescription System when prescribing opioid prescriptions. Go to MAPS to register, then you can request reports at any time.

CDC says doctors should communicate to patients about opioid use
The Centers for Disease Control and Prevention advises doctors to provide some education to patients about opioid use. Doctors and patients should talk about:

• How opioids can reduce pain during short-term use, but how there isn’t enough evidence to suggest that opioids control chronic pain effectively with long-term use
• Nonopioid treatments (such as exercise, nonopioid medications and cognitive behavioral therapy) that can be effective with less risk
• Importance of regular follow-up
• Precautions that can be taken to decrease risks, including checking drug monitoring databases, conducting urine drug testing and prescribing naloxone, if needed, to prevent fatal overdose
• Protecting your family and friends by storing opioids in a secure, locked location and safely disposing unused opioids

To see the CDC fact sheet on the topic, click here.

Opioids in the news
In the November – December issue of Hospital and Physician Update, we provided a roundup of some recent news stories about opioids. You can check it out by clicking here.

For more information on efforts to battle the opioid epidemic, see the article on Drug Take Back Day, also in this issue.