Cullman Senior Magazine Summer 2019 - Page 49

Potential Signs of Opioid Addiction If you suspect yourself, a friend or loved one may have an opiate addiction; there are ways to overcome this addiction that can lead to a happier and health- ier life. The fi st step is to seek help, second – fi d a healthcare professional that can assess the addiction and develop a treatment plan. Treatment can be on an outpatient basis, inpatient (hospitalization) or at an inpatient addiction center. The most successful treatment programs incorporate age specific reat- ment. You hold the key to your own recovery. Th s statement from the American Society of Ag- ing sums it up; “The majority of people who use pain relievers (opiates) do not misuse their prescriptions, but when they do the consequences can be deadly. With so many older adults living with some form of pain, society must wrestle with the balance between providing patients with safe and effective pain treat- ments and not over-prescribing opioids or providing them to people who misuse them”. OPIOID PRESCRIPTION LIMITS AND MEDICARE PART D (DRUG PLANS) • Opioid prescription limitations and checks for all Part D enrollees – This requires Part D sponsors to limit initial opioid prescription fills for the treatment of acute pain to no more than a 7-day supply. Part D sponsors must also im- plement a flag at 90 MME (morphine milligram equivalent) per day, so when a beneficiary reac - es that limit, the pharmacist must consult with the prescriber, document the discussion, and if the prescriber confirms intent, uses an override code that specifically states that the prescriber has been consulted. • Limitations on Part D enrollees considered “at risk” for prescription drug abuse – Part D plan sponsors must establish a drug manage- • Opiate use or dosage increases, yet function continues to decline • Opiate is used longer than originally prescribed • The medication is being taken for reasons other than pain, such as when the person is feeling anxious, bored or depressed • Use of the opiate produces a feeling of being high • The individual tries to decrease opiate use, but is unable to do so on their own • Excessive amount of time spent procuring opiates or seeks out other drugs if opiates cannot be secured • Strong urges or cravings for opiates despite being aware of their negative consequences • Withdrawal from social and recreational activities once enjoyed • Engaging in reckless behaviors more frequently • Experiencing withdrawal symptoms such as diarrhea, sweating and moodiness if the drug is not taken in a consistent timely manner. ment program for beneficiaries deemed at risk for prescription drug abuse. “At risk beneficiaries” are identified as those who take a specific dosage o opioids and/or obtain them from multiple prescrib- ers and multiple pharmacies. Plans may utilize a “lock in” provision to limit at-risk beneficiaries access to coverage of frequently abused drugs to a selected prescriber(s) and pharmacy(ies) after case management with the prescribers and beneficiaries. • Limitations of the Part D Special Enrollment Period for LIS dual eligible – this rule chang- es the Special Enrollment Period (SEP) for dual eligible and Part D Low Income Subsidy (LIS) beneficiaries from monthly to quarterly during the first nine months of the yea . Resource: ncoa.org/blog/whats-new-for-medicare-in-2019/ RESOURCES FOR THIS ARTICLE: - Report.nih.gov/nihfactsheets/viewfactsheets.aspx - Chau, D.L., Walker, V., Pai, L. Cho, L.M. “Opiates and Elderly: Use and Side Effects”, Clinical Interventions in Aging, 3(2008): issue 2, 276 - Krebs, E., Paudel, M., Taylor, B.C., Bauer, D.C., Fink, H.A., Lane, N.E., and Ensrud, K.E., “Association of Opioids with Falls, Fractures, and Physical Performance among Older Men with Persistent Musculoskeletal Pain”, Journal of General Internal Medicine. 31 (2015): Issue 5, 463-469 - www.medscape.com/viewarticle/804369; accessed on 1/31/2019 - www.uspharmacist.com/article/special-consiserations-for-opioid-use-in-elderly- patients-with-chronic-pain; accessed on 1/31/2019 - www.addictioncenter.com/addiction/elderly; accessed 3/15/2019 - www.asagin.org/blog/rural-older-adults-hit-hard-opioid-epidemic; accessed 1/31/2019 CULLMAN COUNTY SENIOR MAGAZINE SUMMER 2019 | 49