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The opioid epidemic: How we're turning talk into action

The opioid epidemic is one of the most talked-about and devastating problems we face every day in North Carolina. For the longest time, it seemed like there was a lot of talk and not a lot of action.

Political and community leaders, law enforcement, and health care organizations saw firsthand how critical the problem was becoming and talked about ways to address it. But the number of opioid-related deaths in North Carolina kept climbing to shocking levels: Up 55 percent from 2014 to 2016, according to the U.S. Centers for Disease Control and Prevention.

$10 million community investment

These kinds of statistics show just how severe the problem has become in North Carolina and how it’s going to take a lot more action to solve.

At Blue Cross and Blue Shield of North Carolina (Blue Cross NC), we recognized the urgency to address the opioid epidemic several years ago and started working quickly to meet the challenge. We have evidence that many of our efforts are working. But we know we must remain focused to greatly reduce the number of lives lost and families shattered.

That’s why we recently announced a $10 million investment in community health initiatives to combat opioids.

Two of these initiatives are:

  • $1 million donation to TROSA to help the Durham-based substance abuse recovery program create new capacity in the Triad area and improve access to Western North Carolina residents.
  • $390,000 to the UNC School of Government to develop community-based resources and programs, working with SOG faculty and staff, in 10 communities hit hard by opioid addiction.

Our way of approaching the problem is to work closely and collaboratively with others. This includes providers, pharmacists, pharmaceutical companies, government officials, and employers, all of whom can help identify strategies to deal with the crisis now and prevent opioid addiction in the future. No problem of this size can be solved by any single entity.

STOP Act and other limits

Sometime over the past year or two, the tide finally began to change in favor of more action and less talk.

The General Assembly approved the STOP Act last year, and Gov. Cooper signed it into law. It includes many provisions, among them a limit on first-time prescriptions of certain drugs and a requirement that prescribers of opioids check the Controlled Substance Reporting System database.

Long before the STOP Act, Blue Cross NC already placed certain limits on opioids to help ensure their use was medically indicated and appropriate.

In 2016 we fought the pharmaceutical industry, which wanted to make a certain class of opioids much easier for providers to prescribe and patients to get. These so-called abuse-deterrent opioids are often marketed as “safer” drugs but have not lived up to these claims. Fortunately, the effort to make opioids more available in North Carolina failed.

In early 2017 we formed a company workgroup to bring together resources and teams in the company to fight the epidemic. We also joined the Payers’ Council, a group set up by the North Carolina Department of Health and Human Resources to bring insurers and others together to explore solutions.

The payoff: 16% decline in prescriptions

When we look at our data, we find some trends that show our efforts are paying off. Since 2013, we’ve seen a 16 percent decline in the total number of opioid prescriptions.

Our philosophy is that patients should get the right medication at the right time. As a pain management specialist, I understand that opioids are indicated and appropriate for some patients. Often they’re only necessary for a short period of time. Or they might not be needed at all. There are many instances in which a non-drug complementary therapy, like physical therapy or chiropractic care, may be an alternative.

The opioid epidemic is one of the greatest threats to public health in generations. Across North Carolina, those of us working to solve this problem are encouraged by a sense of energy, urgency and focus on getting this accomplished. We have a ways to go, but at least we’ve moved beyond simply talking about the problem.

Anuradha Rao-Patel, MD

Anuradha Rao-Patel, MD

Medical Director

Anuradha Rao-Patel, MD, is a medical director at Blue Cross NC. She 'ss responsible for the evaluation of the medical necessity, appropriateness and efficiency of the use of health care services, procedures, prescription drugs and facilities under the provisions of the applicable health benefits plan.

Before joining Blue Cross NC, she worked in a private practice doing acute and chronic pain management.

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