Ensuring powerful pain medications are not abused and get to patients who need them is a key challenge today for opioid management programs amid a nationwide addiction epidemic, says Tyson Thompson, PharmD, of UMass Medical School’s Clinical Pharmacy Services.
However, state Medicaid officials and others overseeing opioid management programs can help keep a tight lid on potential abuse of these drugs through careful vigilance, notes Thompson, a clinical consultant pharmacist who works with state agencies and Medicaid programs.
That means both tracking the larger trends – prescribing patterns for opioids – as well as individual cases where a prescription of an opioid to a particular patient raises red flags.
For an opioid management program to be effective, a working group or dedicated subject matter experts are needed in order to track these trends and intervene when necessary, Thompson advises.
To be most effective, this monitoring team needs to ability to flag a potentially problematic prescription and then work with the doctor who wrote it.
“When needed, that is the quickest way to address the issue or to find out what’s going on with the patient,” Thompson says.
An example of this approach is the Opioid Therapeutic Class Management Workgroup for MassHealth, the Massachusetts Medicaid program.
Developed by UMass Medical School, the opioid management group goes far beyond policy discussions to “get down to the member level and into more complex member cases,” notes Thompson, who helps run the program.
The initiative has led to a drop in the overall use of opioid-based medications, including a reduction in average daily doses and a decline in total drug costs.
The aim, Thompson notes, is to form “collaborative relationship with the prescriber” that can lead to suggestions on changes the doctor can make to “drive safe and judicious opioid use.”