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AMCP 2016

Improving Treatment of Opioid Addiction and Preventing Abuse

Laura Joszt
The drug abuse epidemic in the US has placed attention on opioids and panelists during a session at the AMCP Managed Care & Specialty Pharmacy Annual Meeting 2016 discussed the current state of treatment for opioid addiction and future changes that may be on the way.
Gary M. Henschen, MD, chief medical officer-behavioral health at Magellan Health, explained solutions for substance use, primarily: medication-assisted treatment, office-based opioid treatment, ambulatory detoxification, identifying and treating co-occurring disorders, and screening tools and processes.
Magellan developed an initiative to find out if medication-assisted treatment worked. At the time of discharge, a care manager would ask if the attending physician had considered medication-assisted treatment. If they hadn’t, they would receive educational materials to explain the efficacy of medication-assisted treatment. The initiative also wanted to intervene early and identify patients at risk and get them into treatment early.
Identifying patients who are at risk for opioid abuse means the use of an algorithm that is based on the number of prescriptions filled in the last 90 days, and morphine equivalent dose.
Finally, Reginia Grayson Benjamin, JD, BS, director of legislative affairs at AMCP, ran through the latest federal legislative efforts. Notably, there is a bill called the Comprehensive Addiction and Recovery Act (CARA), which has passed the Senate and is now in the House. The bill is designed to be a comprehensive approach to prevention, education, treatment recovery, and law enforcement efforts to address opioid and heroin addiction.
However, there are 5 other bills pending related to substance abuse, such as the Recovery Enhancement for Addiction Treatment Act, which would increase the number of patients a prescribing doctor can prescribe buprenorphine for opioid addiction.
In addition to the federal legislation pending, there have been state actions in response to increased opioid use. Nearly all states (45) have laws that provide immunity to people who administer naloxone, plus there are laws to promote training and education on recognizing and preventing overdoses.
On top of these efforts, CDC released on March 15, 2016, a new guideline for prescribing opioids for chronic pain.
“There is action basically on every front on opioids,” Benjamin said. “It seems everyone agrees, and finally admits, there is a problem.”

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