Opioid Addiction: The Painful Reality

For years, Express Scripts has been committed to managing concerns about long term opioid use, especially the risk for addiction.


new report from the U.S. Surgeon General highlights the rise of addiction to drugs and alcohol and calls for a deeper investment in pain management strategies. This first-ever report intended for health care providers, law enforcement, and policy makers focuses on numerous prevention and treatment methods available and the vision for a future with reduced stigma on alcohol, drugs and addiction.


The SAMHSA (Substance Abuse and Mental Health Services Administration), a federal agency charged with advancing the behavior health of the nation, contributed much of the data and analytics.


In 1964, a similar in-depth and prescient report regarding tobacco use is now considered to have been the catalyst for change in that industry, and many hope for a similar result from this Surgeon General report.



Express Scripts Commitment


For years, Express Scripts’ workers’ compensation team has been committed to managing both the clinical and cost concerns with long-term opioid use, especially the risk for addiction.


We have continued to build proactive solutions to address the issue from multiple angles. These solutions are focused on helping payers, physicians, risk managers and injured workers arm themselves with tools to ensure safe and cost-effective treatment.


Enhancements to the Express Scripts’ workers’ compensation program offering over the past year have focused on proactive intervention. New in 2016, ScriptAlert+SM, a bundle of point-of-sale edits can be used by workers’ compensation payers to review high-risk prescriptions before the injured worker leaves the pharmacy. This point-of-sale review is carried out in real-time, using OASIS – Express Scripts’ real-time connectivity platform, at the time that a prescription is submitted for filling at a pharmacy. In tandem with the Morphine Equivalent Dose program, Express Scripts proactive opioid programs attempt to tackle the potential of opioid addiction before it begins.



Looking Forward


Just as the Surgeon General calls for more advanced tactics to managing pain, we continue to evolve our solutions. We know that traditional opioid abuse programs identify suspicious activity that’s already happened – by which time behavior modification is extremely difficult. Looking forward, we’re leveraging our advanced analytics to identify and assign risk scores among patients, pharmacies, and even prescribers.



Author Brigette Nelson, MS, PharmD, BCNP, Senior Vice President of Workers’ Compensation Clinical Management, Express Scripts. In this role, Brigette provides strategic oversight for clinical programs for workers’ compensation PBM clients and leads a team of clinical pharmacists and technicians, with client-facing responsibilities for clinical program offerings. She also partners with the workers’ compensation product group in managing clinical programs and consults with clients regarding clinical outcome trend analysis to manage drug spend and appropriate therapy. http://lab.express-scripts.com/lab/insights/workers-compensation

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