Opioid prescriptions at Monroe County’s largest health insurer have decreased, even as deaths from opioids have continued to climb.
Excellus BlueCross BlueShield’s prescribers in Rochester wrote 33 percent fewer opioid prescriptions per patient last year than in 2013, the company’s data show. Excellus corporate medical director Martin Lustick said the numbers are encouraging, but he also acknowledged a need to keep improving.
“It’s good news in that it’s clear we’re moving in the right direction. We know that there are still people dying every day from opioid overdoses, but the good news is that we are decreasing the number of prescriptions significantly over the last five years,” Lustick said.
During the five-year period in which Excellus’s opioid prescriptions dropped by a third, deaths due to opioid overdoses in Monroe County quadrupled.
(Story continues after graphic.)
There is often a long delay between reducing prescription rates and slowing addiction rates, said Monroe County Public Health Commissioner Michael Mendoza.
It is unclear how long it will take for addictions to decline after the drop in prescriptions, Lustick said.
The federal Centers for Disease Control and Prevention publishes guidelines for opioid prescriptions. Lustick credited the decline in Excellus prescriptions partly to requirements passed by New York state in 2016 that oblige prescribers to meet the CDC guidelines the first time they give opioids to a patient. But that rule doesn’t require doctors to follow the guidelines for any subsequent prescriptions, and only 51 percent of Excellus-insured doctors in Rochester met the recommendations for all their prescriptions in 2017.
Lustick said that as Excellus focused on reducing the number of prescriptions, doctors might be writing scripts for larger doses of opioids. “There is absolutely room for improvement,” he said
Excellus expects some of that improvement to come from better educating physicians about best practices for opioid prescriptions. He pointed specifically to a program Excellus started recently that lets doctors consult experts on how to treat patients who are working through difficult addictions. Continued education for physicians is key to lowering the addiction rate, Lustick said.