Archives     Advertise     Editorial Calendar     Subscribe     Contact Us    

Reducing the Risks of Addiction One Prescription at a Time


"Prevention is preferable to cure." These words are part of the modern Hippocratic Oath, which guide my work and the work of my fellow physicians across our state. Today we are facing a crisis that demands a preventive solution: prescription painkiller abuse.

The stakes are real - I've heard too many heart-wrenching tales of lives lost and families torn apart. We know many of these addicts never intended to be drug abusers, but began with a real need to treat pain from injuries or other medical conditions.

And the vast majority of prescribers are doing what is in the best interest of their patients to effectively manage pain. Yet despite good intentions and their best efforts, opioid prescriptions and addiction have escalated in the last decade, along with drug overdose deaths.

At BlueCross BlueShield of Tennessee, we covered one million opioid prescriptions for our members in 2015. That scale has given us deep insights on usage patterns that uniquely position us to help prevent painkiller abuse before it starts.

We launched a public health initiative in 2016 guided by an external panel of clinicians with pain management expertise. Our first goal is to educate prescribers on best practices for opioid use. Another is to change prescribing patterns and place quantity controls to reduce the harmful effects these drugs have on some members.

We began our phased approach this year with modest quantity limits and prior authorization (PA) requirements for new long-acting opioid prescriptions. The PA will ensure that providers are discussing a treatment plan and medication history with their patients before writing a prescription for chronic pain management

Our intent was to phase in changes without throwing anyone into crisis. To date, we've been successful with only minor disruptions. It is also important to note we are granting immediate exceptions for members undergoing oncology and end-of-life care

On Jan. 1, 2017, we implemented the next round of prescription pain medication changes based on CDC guidelines and provider feedback. These include a PA on all long-acting opioid prescriptions (new or current) for all members with BlueCross pharmacy benefits.

We also set new quantity limits on both long and short-acting opioids.

Finally, we've put in place morphine equivalent dose limits across all pain medication prescriptions. This will provide an objective standard and help manage the cumulative impact of the various opioid drugs a member may be prescribed.

The aim of our efforts is not to deny care or generate cost savings. Our only goal is to reduce the devastating effect that opioids - when overprescribed or not used as intended - have had on Tennessee families and communities.

We know these changes may be met with concern and resistance by some parties. But no one else in our state should have to suffer from painkiller addiction. No mother should have to be told her child has overdosed, and no child should have to be separated from their home as a result of a parent's addiction.

The responsible steps we're taking to prevent misuse and abuse are simply the right thing to do.

Dr. Andrea D. Willis is chief medical officer at BlueCross BlueShield of Tennessee.


Related Articles:

Recent Articles

The 2019 Legislative Agenda

A new governor and many new legislators make 2019 a learning year as the state's top healthcare organizations seek to address a number of old issues and tweak some new solutions unveiled last year.

Read More

Updated Cholesterol Guidelines Take a Personalized Approach

The American Heart Association and American College of Cardiology released updated cholesterol clinical guidelines in November 2018, taking a more nuanced approach to care over a patient's lifetime.

Read More

Sharing Data, Saving Lives

In an increasingly connected medical ecosystem where patient safety, health status improvement, and provider reimbursement are impacted at every point along the continuum, the need to efficiently, securely share data appears to have reached a tipping point.

Read More

New Rules in Heart Disease

A number of guideline changes and updates warrant more education around statin use and blood pressure monitoring, but local cardiologists say the higher standards are a game changer.

Read More

Dr. Ashish Shah: A Heart for Transplant Patients

Dr. Ashish Shah is the driving force behind the growth and innovation at one of the nation's busiest heart transplant programs.

Read More

Heart Monitor

Cardiovascular news of note.

Read More

ECMO Program Thriving at TriStar Centennial

A TriStar Centennial, a team approach is key to hospital's successful ECMO program.

Read More

Alexander Looks for Innovation, Asks Council Fellows for Input

Sen. Lamar Alexander asks stakeholders and future leaders to weigh in on ways to improve health outcomes, lower costs.

Read More

CMS Utilizes Dartboard Approach to Modernizing the Medicare Drug Benefit

Controlling pharmaceutical prices remains a hot topic, judging from the 6,415 comments received in response to the CMS proposed rule: "Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses."

Read More

A Conversation with LHC Director Molly Vice

Every company should have a succession plan. LHC plays a key role in planning for the next generation of leaders for an entire industry.

Read More

Email Print



Powered by Bondware
News Publishing Software

The browser you are using is outdated!

You may not be getting all you can out of your browsing experience
and may be open to security risks!

Consider upgrading to the latest version of your browser or choose on below: