The following is an excerpt from an article appearing in the American Journal of Managed Care (AJMC)

One out of four patients who receive long-term opioid therapy in primary care settings struggle with opioid use disorder (OUD), according to Centers for Disease Control and Prevention research. While conversations around opioid addiction are beginning to impact physician prescribing patterns, there is still much progress to be made around treatment and recovery solutions for those battling OUD.

One important option that requires greater attention: the need to leverage an integrated team approach in opioid treatment and recovery.

Recent research points to the value of a holistic approach to opioid recovery delivered in a community setting. Such an approach may include relapse prevention medications; group and individual counseling; physician visits for medication management; mental health therapy; and psychiatric treatment for cooccurring disorders. But there are barriers to accessing holistic opioid recovery treatment within the patient’s community. Such barriers can include lack of mental health resources, stigmas associated with certain treatment options, limited availability of specialized providers, difficulties navigating the complexities of substance abuse treatment, and insufficient capacity.

Overcoming the challenges to a holistic approach to opioid recovery is critical to engaging patients safely and comfortably and supporting sustained recovery. The following five elements contribute to a successful integrated approach.

You can read the rest of the article in the American Journal of Managed Care (AJMC).

Magellan Health today announced the launch of a new thought leadership website, www.MagellanHealthResources.com.

With a curated assortment of materials, focused around individual topics, Magellan Health Resources was designed as a repository of research, information and materials for healthcare professionals, members of the media and researchers.

To launch, Magellan Health Resources is showcasing information and materials around the opioid crisis.

The site includes videos  webinars, downloadable white papers, research, a news archive and more.

You can take a look here

The following is an excerpt from an article appearing in the American Journal of Managed Care (AJMC)

More than 46 Americans die from prescription opioid overdoses every day, while the number of deaths from prescription opioids has more than quadrupled since 1999. Lack of expertise on how to measure and treat pain is a large factor driving the crisis. In addition, challenges in identifying those who are at risk for opioid abuse or who are already dependent on opioids adds further complexity.

Americans consume 80% of opioid painkillers produced worldwide. Yet the amount of pain reported hasn’t changed since in the past 2 decades, according to the CDC. For physicians, this points to the need to reconsider when to prescribe an opioid—if at all. Providers face intense pressures to adequately treat pain and may not know the data that supports nonopioid therapies.

Breaking the cycle of prescription opioid abuse requires new thinking around pain management and alternative options for helping patients deal with chronic pain. The following are 6 things physicians should consider before prescribing an opioid.

You can read the rest of this article in the American Journal of Managed Care (AJMC)

This article first appeared on KevinMD.com. You can read it here.

After being prescribed opioids for just one day, individuals can face significant challenges with addiction, with six percent continuing to use opioids a year later, according to the Centers for Disease Control and Prevention (CDC). The likelihood of long-term use increases sharply after five days of use.

While much of the discussion around the opioid epidemic has centered on the challenges of opioid use and recovery, to get to the root of this national public health emergency, providers must focus on diminishing the risk of addiction before patients take their first dose.

How can providers best help patients reduce the probability of addiction when prescribing opioids? There are five key strategies providers should consider as a first line of protection against dependence and addiction.

Pair patients with chronic pain management coaches. Ideally, this step should be considered before an opioid is prescribed. Pain management coaches use digital therapy and motivational interviewing to help patients manage their pain without turning to opioids. When patients are prescribed a short-term dose of opioids, pain management coaches can be used to help transition patients off opioids by teaching techniques to manage pain without turning to opioids.

Partner with behavioral health experts who can identify patients who are most at risk of addiction. To avoid an opioid addiction before it starts, providers must understand the factors that increase patients’ risk of becoming addicted. These include behavioral health conditions such as depression and post-traumatic stress disorder—conditions that contribute to the experience of pain. Look for tools that can help identify patients’ behavioral health risk factors at the point of care, and establish partnerships with behavioral health professionals that help ensure patients also have access to pyschosocial treatment as needed. Some behavioral health solutions enable patients to participate in their treatment virtually, providing access to care for rural patients for whose availability to local behavioral health resources presents greater challenges.

Follow best practices on dosing limits. Ensure the morphine milligram equivalent dose and duration of treatment prescribed follow CDC and Centers for Medicare & Medicaid Services (CMS) best practices. Consider non-opiate alternatives before prescribing opioids, and carefully evaluate whether long- or short-acting opioids should be used based on CDC and evidence-based guidance.

It’s also important to collaborate with payers and pharmacists to gain visibility into patients’ past history of opioid use and evidence of previous substance abuse prior to writing a prescription. Patients who are at high risk of becoming addicted to opioids include those who have faced challenges with addiction in the past and who frequently visit the emergency department for pain relief. This information could help determine whether opioids are prescribed and, if so, the specific dose and duration of treatment.

Proactively engage patients in their treatment. Educate patients on the use of non-opioid medications that are just as effective as opioids.  When opioids are necessary, talk to patients who have been prescribed opioids for the first time on how they work, the risks of opioid use, and how to use opioids appropriately to reduce the risk of addiction. Consider this being much like informed consent before any medical procedure. Look for ways to engage patients not only in managing their use of opioids, but also in managing their physical and behavioral health, before, during and after using opioids.

Offer 24/7 access to healthcare professionals for patients who have been prescribed opioids. Doing so will provide a critical resource for patients who need help understanding their opioid prescription or feel as if they have a problem managing their response to their medication. Know your state’s Good Samaritan laws to ensure users of opioids that it is safe for them to seek care. Consider a hotline for opioid-using patients, staffed by nurses or an outside service to give patients and providers instant access to expert guidance.

Best practices for a complex challenge

As the opioid crisis continues to evolve, understanding the factors that place patients at highest risk of addiction before opioids are prescribed is key. Taking proactive measures to evaluate whether opioids are truly needed and how to best manage patients’ use of and response to these highly addictive drugs is critical to helping patients avoid serious health complications and live healthy, vibrant lives.

Today, much of the conversation around opioid use focuses on ways to more tightly control access, including limits on usage and the mandatory use of databases that can alert physicians to patients’ opioid histories. But for those suffering from Opioid Use Disorder (OUD), combatting addiction is a difficult feat, particularly due to treatment barriers, lack of qualified providers, and waitlists for evidence-based treatments.

Read the rest of this article here

Every day in the news we hear about the devastating impact of the opioid crisis across the country. While we need to confront this complicated crisis, we also need to examine the larger issue of substance use disorders (SUD) that impact millions of Americans.

This past September, I had the honor to represent Magellan Health at the first meeting of the Substance Use Disorder Treatment Task Force, founded by Shatterproof. The mission of the task force is, “To fundamentally improve substance use disorder treatment in the United States, in terms of both quality and patient outcomes.” It also addresses the underlying cause of our country’s current substance use crisis, and lack of access to quality and evidence-based treatment. The task force has been created to expand access to quality treatment for the estimated 21 million Americans with SUD.

This task force is unique in that it convenes public and private healthcare companies, advocates and former government officials to take the lead in developing a tactical plan with measurable goals for payers to follow and implement. I am proud to be joined by so many colleagues and experts across the industry.

Our first focus is to implement the recommendations outlined in the November 2016 Surgeon General’s Report on Alcohol, Drugs, and Health. Secondly, we will utilize methods outlined in a 2006 report from the Institute of Medicine which recommends the need for a group of government regulators, accrediting organizations, consumer representatives, providers and purchasers to come together to develop a common, continually improving set of quality measures, specifically for mental health and substance use disorders.

The work of this task force aligns nicely with our efforts at Magellan, helping lead individuals to healthy, vibrant lives. Working with individuals with SUD, from both the behavioral health and the pharmacy benefits management perspective, we are in a unique position to help address these issues. I believe we can make significant contributions on this task force and for the benefit of our customers, members and providers with whom we work.

A study by a team of Magellan researchers, demonstrating the pervasiveness of opioid addiction, was featured on CBS Philly (KYW).

The study, an analysis of medical and pharmacy data from 2009—2012 for 2.5 million people aged 20-64 who were part of a commercial health plan, showed that 48 percent of patients who had stopped using opioids for at least six months went on to use them again.

You can read more about the study by clicking here.

Written by Thomas Lane, NCPS, CRPS

September is National Recovery Month, and during this time, we celebrate the fact that people living with mental health and substance use disorders can and do recover.  Recovery is real.  But what does it mean to recover?  It’s an important question, and there is no simple answer.  Each individual experiences recovery in unique ways.  As a person in recovery, here is what I believe we have in common.

Hope – We all need hope in our lives.  Hope is like a beacon, a light that shines in our lives and in the lives of others.  It is vital.  But there are times when we lose hope.  It’s in those times we need someone to hold the hope for us.  Hope doesn’t cost anything to give, yet it is priceless.

Self-determination – Self-determination is a fundamental value in our lives. For many of us, our choices have been limited due to the impact of our mental health or substance use disorders.  Some of us live with both.  There are times when conditions are imposed on us that are not consistent with our own goals and aspirations.  Self-determination is so important, because without it, we can feel hopeless and without control in our lives.  Decision support tools and opportunities to strengthen self-efficacy empower us to choose self-determined roles in communities of our choice.

Connectedness – We are interdependent.  Connections to others and meaningful relationships are human needs.  Without connections, we can feel isolated. Developing circles of support and being included strengthens our recovery.  We are part of our communities and cultures, not separate from them.

Health  – Many of us live with chronic health conditions.  In fact, the average life expectancy for a person living with a serious mental health condition is twenty five years shorter than the general population. Finding good health care professionals who support improvements in our health and conditions, beyond just symptom and illness management, helps us realize improved personal health outcomes.   We develop healthy living habits.  Good nutrition, exercise, restful sleep; we are intentional in our approach to live well.

Peer Support – To me, peer support is the bedrock for recovery.  When someone shares experiences we can relate to, experiences we may have in common, we discover we are not alone.  We discover others have made it through similar difficult times and overcome similar challenges.  We are encouraged.  We gain confidence.  We rediscover hope.  And we pay it forward.

As I think about this year’s National Recovery Month, I know from my own experience that recovery is not a straight path.  I know there may be setbacks and hurdles to overcome.  But I am absolutely convinced that recovery is real.  It happens when we have hope in our lives, when we have choices, and when we are connected to each other and our communities.   It happens when our health care needs are met and we work to become healthier.  For so many of us, peer support represents the beginning of our journey.  Let us celebrate each person’s pathway, honor each person’s journey, and welcome those who walk alongside us.