Insurance Providers Help Families Address Teen Opioid Addiction

posted by Chris Regal, AHIP, Director, Clinical Innovations

on January 15, 2020

When a family member suffers from substance use disorder (SUD), the impacts are widespread. Whether it’s a parent suffering from opioid addiction, or a teenager, the impact can ripple throughout the family, both emotionally and physically.

The voice of the family is seldom sufficiently acknowledged when experts address the opioid epidemic, according to Dr. Dennis Daley, UPMC Health Plan’s Senior Clinical Director in the Substance Use Services Behavioral Health Integration Division and Professor of Psychiatry at the University of Pittsburgh Medical School. As such, UPMC created a four-pronged approach to looping the family into efforts to combat the opioid epidemic: Advocating on behalf of members, patients, families, and children; disseminating information, such as articles, blog posts, recovery guides, and videos; educating members, families, providers, and the community; and facilitating screening, evaluation, education, programs, and services.

An estimated 170,000 children suffer from opioid use disorders or have accidentally ingested opioids, and the mortality rate for pediatric deaths from prescription and illicit opioids has tripled since 1999. Nearly 9,000 children and adolescents died from opioid poisonings between 1999 and 2016, and there were almost 5,000 opioid-related overdoses and deaths among adolescents and young adults in 2017. Over 3% of teens reported misusing an opioid in 2016.

Limited screening for opioid use in teen and adolescent primary care visits remains a challenge, and the U.S. Preventive Services Task Force has determined that there is insufficient evidence to assess the balance of benefits and harms of primary care-based behavioral counseling interventions to prevent or reduce illicit drug use.

Despite these challenges, the strategies outlined by UPMC to account for the needs of the family ring true when addressing opioid use disorders in young people. To address addiction among teens and adolescents, stakeholders – including parents, siblings, schools, clinicians, and other community members – must take action to reverse alarming trends. Insurance providers are taking a variety of actions to proactively work with their members to prevent and treat patients who suffer from substance use disorders:

  • Patient and parent education: Numerous health insurance providers, including Aetna, Delta Dental, and Independence Blue Cross, offer resources for families to talk about opioids and addiction. These resources also encourage parents to speak with providers about how to manage pain and how any opioids may be prescribed.
  • Provider education: Cigna and Kaiser Permanente are working with providers to manage pain safely. Cigna has created a program to work with dentists about safe and appropriate opioid prescribing and Kaiser Permanente has revised its provider best practices on how to address pain following pediatric tonsillectomy without the use of opioids.
  • Analytics: Blue Cross and Blue Shield of Louisiana is using claims analysis to determine who might be struggling with addiction. The insurance provider reviews members’ emergency department visits over a specified period, which could indicate that the person is chasing prescriptions.
  • Expanding access to treatment and recovery care: Anthem has introduced enhanced screenings and case management for children who may be suffering from substance use disorders and actively works with providers to extend the availability of medication-assisted treatment.
  • Engage in partnerships: Numerous insurance providers have partnered with local and national organizations working to combat the opioid epidemic (e.g., Shatterproof) and work with network providers to implement best practices outlined by the American Academy of Pediatrics.

Get more information on how insurance providers are addressing the opioid epidemic.

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