Safer Pain Care

What is an opioid? Opioids are narcotic drugs used to treat pain. Opioids come in short- and long-acting forms.

Read further to learn what you can do to take doctor-ordered pain drugs safely and how to dispose of them when you no longer need them. 

Ask your doctor about other choices:
There may be other ways to treat your pain, such as non-narcotic, non-opioid drugs or physical therapy. Talk to your doctor or pharmacist if you are worried about possible side effects of a drug, including physical dependence and addiction.

• First, let your doctor know if you have a history of substance abuse. That way, he or she can closely monitor you for any signs of dependence on your medicine.
• Always follow your doctor’s or pharmacist’s directions when taking a prescription drug.
• Take only the amount your doctor prescribes. Taking even one extra dose can be dangerous.
• Never take a drug prescribed for someone else or share your prescribed drugs with others.
• Never crush or split your pain pills. Some pills are designed to slowly release medicine into your bloodstream. Breaking them up may give you too much at once.
• Mixing medicines with pain drugs can be dangerous, even deadly. Tell your doctor about any other drugs, including alcohol, vitamins and any over-the-counter medicines you take.

Safely store your pain medicine:

• Store drugs in their original containers. The package labels have important information you may need.
• Don’t keep them in the usual place, like a medicine cabinet. Hide them in a hard-to-find place or store them in a lockbox or safe.
• Keep all drugs away from kids and pets.

How and When to Stop Taking a Drug:

• Do a drug check. Bring all of your drugs to your doctor at least once a year and ask him or her if you need to stop taking any of them.
• Don’t stop on your own-make a plan with your doctor. Some drugs may need to be stopped slowly and may cause serious health problems if you stop them too quickly. Call your doctor before changing how much of any drug you take. Work out a stop schedule with your doctor that includes follow-up visits.
• Know the warning signs. Get a list of the symptoms that may happen from stopping the drug you’re taking, and call your doctor if you notice any.

Safely dispose of your leftover drugs:
When you finish taking a drug, if you have any left over, get rid of them safely so they aren’t stolen or misused. Some law enforcement agencies will let you turn in leftover drugs through secure disposal boxes-no questions asked. Find a safe drug drop box near you at www.bcbsla.com/safedrugdrop.

How to get help for opioid dependency

• New Directions manages behavioral health benefits for Blue Cross and Blue Shield of Louisiana members. New Directions can connect you to the most effective treatment for your specific needs and answer any questions you have.
• Call 1-800-991-5638 for more information.

BLUE CROSS’ POLICY ON OPIOIDS:

For an opioid drug to be covered under your plan, you may have a limit on how many days’ supply of certain drugs you can fill at a time, or your doctor may need to ask for prior authorization before you fill an opioid drug. We will make exceptions for members who are already on long‐term pain medicines if they meet certain criteria, and for people taking these drugs because they have cancer or are receiving end‐of‐life care.

Combination pain medicines: Some opioid drugs are combined with an additional pain reliever such as acetaminophen (Tylenol^®), ibuprofen or aspirin. Most of these combinations include Tylenol. By limiting the amount Tylenol you take per day, you can reduce your risk of liver damage.

• Limit Tylenol containing drugs to 3 grams or less of Tylenol per day.

EXAMPLE: There are 3 grams of acetaminophen in 9 tablets per day of hydrocodone/acetaminophen 10/325mg. This means we will cover no more than 9 tablets per day of hydrocodone/acetaminophen 10/325mg.

• Limit ibuprofen/short-acting opioid combination drugs to 5 tablets or less per day.

EXAMPLE: This means we will cover no more than 5 tablets per day of hydrocodone/ibuprofen.

• Limit aspirin/short-acting opioid combination drugs to 4 grams or less of aspirin per day.

EXAMPLE: There are 4 grams of aspirin in 12 tablets of oxycodone/aspirin 4.8355mg/325mg. This means we will cover no more than 12 tablets of oxycodone/aspirin 4.8355mg/325mg.

Your doctor must get approval before these drugs may be covered:

• Short-acting Opioids

EXAMPLES: Percocet^® and generics, Lortab^® and generics, codeine, oxycodone, hydrocodone and others

• Fills for longer than a 7-day supply.
• Fills for more than a total 21-day supply within 60 days’ time.

• Long-acting Opioids

EXAMPLES: Butrans^®, fentanyl patch, OxyContin^®, MS Contin^®, morphine ER, oxycodone ER and others

• Fills for new users.

Our policy aims to decrease the amount of opioids in the community and the number of patients who become chronic opioid users, while still meeting the needs of our members.