Addiction Recovery

Addressing Pain Management & Opioid Use/Abuse

Pain Management & Opioid Abuse Strategies:
Addiction Recovery

Because opioid abuse alters the brain’s structure and function, it results in changes that persist long after the use of the medication has stopped. These changes help explain why the risk of relapse is high and treatment needs to be customized and of adequate length to achieve the best outcomes.1

The first step in the addiction recovery process is medically assisted detoxification in conjunction with individualized counseling and treatment of other co-morbid physical or mental conditions. You may need to work with multiple vendors to ensure comprehensive support is provided at different stages of the recovery process.1

Following are essential recommendations:1

  • Evaluate benefit offerings from your health plan and EAP to ensure you provide comprehensive counseling for employees with opioid use disorder
  • Ensure that coverage for counseling is for a minimum of 90 days in duration
  • Allow for EAP encounter data to be shared with other vendors such as PBMs and health plans
  • Ensure medication coverage for opioid abuse treatment including methadone, buprenorphine or naltrexone, is available through the health plan or PBM
  • Evaluate the counseling options provided by your health plan and EAP to ensure adequate options are readily available to accommodate multiple needs and situations

These may include:1

    • Screenings for depression and anxiety (at no cost for the employee)
    • Confidential substance abuse screening
    • Brief intervention for substance abuse
    • Access and referrals to case/care management services during treatment and recovery
    • Residential treatment - short term (3-6 weeks)
    • Residential treatment - long term (6-12 months)
    • Outpatient programs - low intensity (provides education)
    • Outpatient programs - high intensity (intensive day treatment similar to residential)
    • Sober House following intensive treatment
    • Individual counseling (includes social support in addition to drug counseling)
    • Group Counseling
    • Family Counseling

The ultimate goal of treatment for opioid dependence is discontinuing use of the drugs. The type of treatment provided is important and may include tapering the dose, adding psychotherapy and/or providing pharmacotherapy (including methadone or buprenorphine). For the best chance at success, the patient must stay engaged to avoid undesirable outcomes such as:25

  • Clinician abruptly discontinuing care
  • Patient voluntarily leaving a practice
  • Prescriber not making changes to therapy, even when there is evidence of prescription drug abuse

Each of these can result in missed opportunities to effectively manage the patients use of opioids.1