In response to the Sept. 18 front-page article “Insurers faulted over opioids” (from the New York Times), it should be known that Partnership HealthPlan of California, the nonprofit managed Medi-Cal plan for Sonoma and 13 other counties in Northern California, has been working for years to battle the prescription opioid epidemic locally.
This epidemic threatens the health and well-being of many people who have become dependent and addiction to prescription pain killers. The mandate to treat pain, the realities of an aging population and the desire to treat became a formula resulting in large numbers of patients depending on escalating doses of prescription opioids that not only failed to treat their pain but resulted in dependency, side effects and overdose deaths that outnumbered nationwide motor vehicle deaths.
Add to this the risks of diversion that fueled an illicit economy and endangered youth and our law enforcement officers.
Partnership HealthPlan of California recognized that this trend in prescriptions endangered its members, did not provide effective relief from chronic pain, caused great misery and took the joy out the practice of medicine for many clinicians whose schedules were packed with patients requesting high doses of prescription opioids.
Beginning in 2014, using well-accepted guidelines and in cooperation with primary care clinicians, specialists and pharmacies, Partnership HealthPlan of California developed internal policies and an action plan that included education of clinicians about the opioid epidemic, expanded treatment modalities such as chiropractic and acupuncture, reducing the allowable amount of opioids to be prescribed for acute and chronic pain and expanding the non-opioid formulary for pain.
Partnership HealthPlan of California participated in and, at times, funded the establishment of coalitions in many counties that addressed their local epidemic — the Safe Rx coalitions.
Partnership HealthPlan of California awarded clinicians who became qualified to prescribe medication- assisted treatments, Suboxone, for those with dependency and encouraged the development of local ordinances that made available the antidote to opioid overdose, naloxone.
As a result, the rate of opioid prescription to Partnership HealthPlan of California Medi-Cal members has been reduced by 70 percent. Meanwhile, the initial use of opioids has been reduced by 42 percent, and we now have more than 1,000 fewer members on high dose opioids.
Partnership HealthPlan of California’s cooperative approach to the prescription opioid crisis has resulted in better care, increased access and safer communities.
Dr. Marshall Kubota is regional medical director for Partnership HealthPlan of California and is based in Santa Rosa.