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4 Strategies for Combatting the Third Wave of the Opioid Epidemic: Fentanyl

Caroline Carney, MD, MSc, is the chief medical officer for Magellan Rx Management, the pharmacy benefit management division of Magellan Health. She joined Magellan Health in 2016 and previously served as the chief medical officer for Magellan Healthcare. In her current role, Carney is broadly responsible for supporting Magellan Rx in building differentiated, industry-leading clinical programs and services. Prior to joining Magellan, Carney served in chief medical officer roles, working with Medicare, Medicaid, commercial, and exchange populations. She was trained in and practiced psychiatry, internal medicine, and psychosomatic medicine. Carney has a Master’s degree in preventive medicine, focusing on health services research and epidemiology. She also brings strong public sector expertise having served as medical director for Indiana’s Office of Medicaid Policy and Planning where she oversaw quality, pay for performance, and initiatives for behavioral and physical health.
2. Support access to naloxone
Naloxone can save lives by reversing the effects of an opioid overdose. It’s important to proactively speak with health providers and insurance companies to ensure access to naloxone for those battling opioid addiction.

The US Surgeon General recommends the following groups of people keep naloxone on hand for emergency use:
  • Those currently taking high doses of prescription opioids for pain
  • People who are misusing prescription opioids
  • Individuals taking illicit opioids, such as heroin or fentanyl
  • Healthcare providers
  • Family members whose loved ones suffer from OUD
  • People who regularly come into contact with those at risk of an opioid overdose
Health plans can support access to naloxone through policies that make this medication readily available to those suffering from OUD and their support teams. They should also seek to educate providers on the benefits of access to naloxone for high-risk individuals.

3. Foster safe opioid usage, when necessary
When opioids must be used in treatment, work with providers to establish safe guidelines for use. For example, take steps to ensure the morphine milligram equivalent dose, duration of treatment, and type of opioid prescribed (eg, long- or short-acting opioids) follow the CDC and CMS best practices.

Additionally, pairing those taking opioids with chronic pain management coaches and offering these individuals 24/7 access to healthcare professionals, such as a hotline staffed by nurses or an outside service, will provide a critical resource for members who need help understanding their opioid prescription or feel as if they have a problem managing their response to their medication.  

4. Community involvement
Stay up to date on community, medical, and legal resources directed at combatting addiction and limiting the availability of opioids. For example, the SUPPORT for Patients and Communities Act passed last year provides practical policy solutions for addressing the opioid crisis, including the use of telehealth services for OUD treatment. In communities with limited resources for one-on-one OUD support, telehealth services or a combination of virtual and in-office services provide the basis for an evidence-based approach to care.

It’s also important that health plans, providers, and community groups work together to identify specific populations at risk and develop targeted outreach and recovery support. Such initiatives can help members feel more empowered to successfully recover and transition back into society.

Breaking the Cycle
With new factors continuing to emerge every day in the growing opioid epidemic, now is the time to take proactive measures to better protect communities across the nation. Through education, support for evidence-based treatment and naloxone access, and partnership with families, providers, and community service agencies, we can help ensure those with OUD receive the right support at the right time, putting them back on a path of sobriety and health.

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