If you get injured or have surgery, your doctor may prescribe opioids, a class of drugs used to treat pain.
Although opioids can be an important part of treatment, they carry serious risks of addiction, abuse, and overdose, especially if used continuously. This is true even for seniors and other people with Medicare coverage.
While illicit use is part of the opioid epidemic, prescription opioids provided by physicians can also be a problem when not used carefully. Since Medicare pays for a significant amount of prescription opioids, we strive to ensure appropriate stewardship of these medications that can provide a medical benefit but also pose risks.
That’s why Medicare has developed new policies for Medicare prescription drug (Part D) plans, doctors, and pharmacists to help you use opioids safely. Medicare is also using new drug-management programs to look for potentially high-risk opioid use.
The new policies aren’t “one size fits all.” Instead, they’re tailored for different types of Medicare prescription opioid users. These policies don’t apply to people living in hospices or long-term care facilities, receiving palliative or end-of-life care, or being treated for active cancer-related pain.
When a prescription is filled, Medicare drug plans perform additional safety checks and may send pharmacies an alert to monitor the safe use of opioids and certain other medications.
Safety checks may cover situations like:
• Possible unsafe amounts of opioids. The pharmacist or Medicare drug plan may need to more closely review a prescription with the prescribing doctor if a patient has one or more opioid prescriptions that total more than a certain amount.
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