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Addressing the Opioid Public Health Emergency in New Mexico

According to the Centers for Disease Control and Prevention (CDC) Learn more about third-party links, on average, 115 people in the U.S. die each day from an opioid overdose. Many of these deaths involve prescription opioids, and more than 1,000 people are treated in emergency rooms daily for misusing these drugs.

Many of our members have felt the impact of the opioid crisis in their lives and communities. Blue Cross and Blue Shield of New Mexico (BCBSNM) cares about the health and well-being of our more than 463,000 members and we take this crisis and our role in addressing it seriously.

BCBSNM believes the greatest impact comes from helping members with the proper use and disposal of prescription opioid medication. We do this by building on our relationships with members, care providers and pharmacists. We’re also creating new partnerships to address the opioid crisis in the communities where our members live, work and play.

The opioid crisis is a complex issue. It will take the constant, collaborative effort of health providers, insurers, communities, members and all levels of government working together to develop solutions that can be started in towns nationwide.

Addressing the Public Health Emergency

By working with our health care partners and members in New Mexico, we aim to:

Identify - Use data to identify members who may be at risk of opioid addiction and abuse.
Partner to Prevent - Work with doctors, other health care professionals, and community partners (including first responders and government health agencies) to prevent or reduce the risk of addiction and abuse.
Coordinate Care - Improve the coordination of care for our members in their battle with opioid dependence.
Educate - Conduct ongoing education and outreach about the opioid crisis. This includes treatment options, local support organizations and providers that individuals can turn to for themselves, family and friends.

Leveraging Data to Address the Opioid Crisis

We're expanding our use of data and analytics to identify members who may be in the early stages of opioid addiction. The BCBSNM Controlled Substance Integration (CSI) program brings pharmacists, doctors, special investigations staff, behavioral health specialists and case managers together to identify causes that may lead to drug abuse and help improve member health and wellness.

The CSI member program builds upon BCBSNM’s Controlled Drug Substance program, in which members are identified based on factors that may affect patient safety or when they require additional intervention. Using a multidisciplinary approach, identified members undergo a comprehensive evaluation and a plan of action is executed.

The CSI provider program analyzes prescribing data and informs providers if members are using multiple prescribers and/or pharmacies for controlled substances. When we monitor providers after engaging them with this approach, we see an average 15mg reduction in morphine equivalent daily dose per patient.

Ensuring Safe and Effective Prescription Opioid Use

The next step we’re taking in our overall opioid strategy is starting new safety checks at the point of sale to support safe and effective use of prescription opioids.

On August 1, BCBSNM launched the Appropriate Use of Opioids program, to encourage the proper use of opioids and advocate for patient safety. The program’s safety checks address the acceptable quantity and medication dose, as well as number of sources that may issue medication, as recommended by the CDC Learn more about third-party links and other nationally recognized guidelines.

To avoid unnecessary disruption in current approved drug therapy, the Appropriate Use of Opioids program will use a phased approach over the next several months to implement these point-of-sale safety checks on opioid prescriptions, across our membership*. The program’s safety checks will be in full effect by April 1, 2019.

Members who may have opioid prescriptions that are at or above the program’s established safety requirements will be identified at the point of sale, and the pharmacist will receive a notification of the steps to take before the full quantity as prescribed can be dispensed under the member’s benefits. These safety checks are in addition to current drug dispensing limits.

The safety checks in the Appropriate Use of Opioids program are put in place to lower the chance of opioid-related dangers like overdose and death.

* The Appropriate Use of Opioids program affects employer group and individual plan business, and will not impact Medicaid or Medicare plans, at this time.

Partnering to Prevent Addiction and Abuse

Safe Medication Disposal

BCBSNM promotes National Prescription Drug Takeback Day Learn more about third-party links in our communities twice a year – part of a nationwide effort sponsored by the U.S. Drug Enforcement Administration. Safe medication disposal is one of the best ways to make sure medications are not accidently used or intentionally misused by someone else.

The next National Drug Takeback day is October 26, 2019.

To make it easier and more convenient to safely dispose of unwanted medication, the Blue Cross Blue Shield Association Learn more about third-party links (BCBSA) and BCBSNM are partnering with Walgreens to expand the existing Walgreens Safe Medication Disposal Program. This partnership will increase the number of drug takeback kiosks at Walgreens stores in New Mexico in 2018.

The Walgreens drug takeback kiosks provide a free, year-round solution to dispose of unwanted, unused or expired prescription medications, including controlled substances and over-the-counter medication.

Members can take their extra or expired medications to a Walgreens with a safe disposal kiosk and deposit them. It’s as easy as dropping a letter into a mailbox. The kiosks are available during regular pharmacy hours.

For a full list of Walgreens drug takeback kiosk locations, visit the Walgreens Store Locator Learn more about third-party links

Opioid Policy in New Mexico

On Oct. 24, 2018, the Substance Use–Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (H.R. 6) was signed into law. The SUPPORT Act contains Medicare and Medicaid program enhancements and other changes, new Food and Drug Administration (FDA) requirements, and other public health efforts to help combat the opioid epidemic, such as:

  • Authorizing electronic prescribing of controlled substances under Medicare,
  • Expanding the ability for Medicare Advantage and Part D plans to address suspected pharmacy fraud,
  • Increasing state opportunities to offer in-patient mental health coverage for adult Medicaid beneficiaries,
  • Allowing for expedited FDA review of new, non-addictive drugs for pain treatment, and
  • Making funding available for programs that will prevent and treat opioid addiction.

As federal agencies and states put this law into action, additional regulatory policies will be issued by agencies responsible for implementing provisions of the new law.

BCBSNM continues to work with policymakers at the state and local level to find solutions to the opioid crisis as well as advocate on behalf of our members throughout New Mexico suffering from opioid use disorder.

Last year, New Mexico was awarded CDC funding for prevention for states program – a data driven prevention initiative and enhanced state opioid overdose surveillance. Additionally, the New Mexico Legislative Health and Human Services Committee (LHHS) conducted a day-long Opioid Summit, which included testimony regarding the impact of opioid addiction and round table discussions, and resulted in several recommendations, including: mandating checks on all opioid prescriptions, and regulation of pharmaceuticals.

The New Mexico Prescription Monitoring Program requires dispensers to report within one (1) business day of a prescription being filled, and practitioner are required to check the PMP database when prescribing opioids for the first time, or for a period greater than four days, or if there has been a gap in prescribing the controlled substance from 30 days or more.

Supporting Research to Understand the Opioid Crisis

BCBSNM works closely with the BCBSA Learn more about third-party links in its efforts to address the opioid crisis across the country. To know how the opioid crisis affects our members, BCBSNM worked with the BCBSA to develop The Opioid Epidemic in America: An Update Learn more about third-party links which was released in July 2018. Researchers looked at a 5-year study of medical claims BCBSA and found a 29% drop in opioid prescriptions.

Third-Party Resources