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Balancing the Need for Opioids while Mitigating Risk of Abuse

By Revenue Cycle Advisor  
   March 13, 2018

In order to prevent opioid misuse, case managers need to understand how the problem may develop.

This article was originally published by HCPro's Revenue Cycle Advisor March 13, 2018.

Case managers in today’s healthcare world face a challenge in confronting growing opioid abuse while also managing the use of opioids in certain circumstances as an effective treatment option for acute and chronic pain.

According to CMSA Today, approximately 2.1 million Americans are addicted to prescription opioids while another 467,000 are addicted to heroin.

Although long-term prescription opioid use puts patients at risk for a substance abuse disorder, opioids continue to serve as an effective form of treatment for acute and chronic pain. This puts case managers in a unique position where they must balance patients’ needs for appropriate treatment while being mindful of opioid use disorder risks.


Jury's In: Opioids Are Not Better Than Other Medicines For Chronic Pain


It is therefore important for case managers to understand how opioid misuse can develop to attempt to prevent it from happening.

Prescription opioid misuse is characterized by overuse of medication, use of medication to get high, sharing or selling medication, and illegally obtaining medication, according to CMSA Today.

Case managers should be aware of the following risk factors for opioid use disorder when working with patients:

  • Family history of drug/alcohol use and mental illness
  • History of child abuse or being raised by uninvolved parents
  • Living in an environment that is impoverished or violent
  • Absence of hobbies or interests
  • Lack of economic opportunity

Case managers should also be aware of the following risk factors for opioid overdose:

  • Long-term opioid use
  • History of substance use disorder
  • Diagnosed mental health conditions
  • Criminal history
  • Being Caucasian
  • Being less than 45 years old

Risk factors may vary in that they can change over time based on income, employment, childhood, etc., according to CMSA Today.  

Revenue Cycle Advisor combines all of HCPro's Medicare regulatory and reimbursement resources into one handy and easy-to-access portal. News is not just repeated from other sources. It is analyzed by our Medicare experts so professionals can comprehend any new rule and regulatory updates thoroughly. Learn more.


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