What are opioids and why is this important?

Opioids are strong prescription pain medications, sometimes called narcotics. They are usually prescribed to help ease acute moderate to severe pain because of an injury, illness or surgery. Opioid pain medication blocks pain messages sent from the body to the brain.

Opioids may not ease all of your pain, but they can help you cope with your pain for a few days as your body heals and recovers. Opioids can cause unpleasant side effects and dangerous reactions can occur if you take too much, take them too often, or for too long. Because of these dangers we want to ensure our members are taking this medication appropriately. A study by the Minnesota Department of Human Services (DHS) showed that if a person takes opioids for 45 or more days after a new prescription, they are much more likely to continue taking them for a long time. We want to encourage people to work with their doctors to find other ways to manage their pain during recovery.

What are we doing?

HealthPartners works with other health plans to create educational materials for both clinicians and for our members to understand the issues related to opioids. Together, we created a Provider Toolkit with lots of information and resources to help clinics work with their patients to manage pain.

We created a brochure to educate our members on some of the important issues related to opioid use, a letter that we send to members encouraging them to work with their doctor to find other ways to treat their pain, and a postcard with information on how to store medications safely and dispose of unneeded medication.

We created a website for members to learn more about pain management and options for helping people talk to their doctor and manage their pain.

How do we reach out to members?

When a member has a new prescription for an opioid and they get a refill, we send them a letter explaining some of the risks of opioids and giving information about other treatments that help manage pain. We encourage people to talk to their doctor about their options.

Many SNBC members already use a lot of medications and adding another one can cause problems. When SNBC members refill their prescription, their care coordinator will work with them so the member uses their medications safely.

We also post stories about this issue on our social media sites and work with the local media to raise awareness of the public.

How do we collaborate with providers?

HealthPartners has sent our contracted clinic providers information about the Provider Toolkit so they can utilize this resource. We wrote an article for MN Physician magazine with information about the issue and how the Toolkit can help with clinical practice.

We offer webinars and trainings about the best practices in managing pain and opioids. We share best practices with our network providers through our newsletters and partnerships.

We monitor clinic opioid prescribing patterns and how many of our members become chronic users. We share these reports with providers so they can use this information to improve their care.

What challenges do we face?

Most clinicians do a good job of staying up to date on how they should be prescribing opioids, but not everyone has adopted the Minnesota Opioid Prescribing Guidelines. We will continue to work with our clinics to make sure they are using best practices.

It can be difficult to reach our members with the information. We may not have the most current address or phone number. Some people prefer to continue taking the medication instead of transitioning to something else. It can be scary not knowing how you will manage your pain.

In 2020 members faced unique challenges due to covid 19 such as limited access to surgeries or alternative therapies for pain (such as PT) due to the Governor’s orders in response to the pandemic

Results

HealthPartners data is similar to DHS data showing that if people get a refill of their opioid medication, they are more likely to continue taking the drug for a long time.

Overall, 1.74% of Minnesota Health Care Program (MHCP) members who had an opioid prescription in 2020 became new chronic users. This is 50% decrease in the last 5 years.

In 2020, we sent 3,992 letters to members who got a refill of their prescription opioids. Of these, 8.5% percent became chronic users of opioids compared to 1.74% percent of all members who got any opioid prescription.

We have seen a 16% increase in members who use opioids who also use alternative therapies such as physical therapy, chiropractic care and acupuncture to manage their acute pain.

We have seen that our clinics are making changes to how they prescribe opioids. The average number of pills prescribed, the average morphine equivalent (MME) and the overall percent of members who become chronic users (NCU) all decreased. This is the case for MHCP members as well as commercial members. These are positive trends that we believe will continue due to the strength of our programs.