4 in 5 heroin users started with prescription painkillers.
FOR MEMBERS

Protecting You and Your Family

Understanding how opioids work — and how your health plan is working with you — is the first step toward safe, effective treatment.

WHAT THIS MEANS FOR YOU

A Partnership Built Around Your Safety

Your health plan has partnered with OpioidRx to help identify and prevent opioid-related risks before they escalate — at no additional cost to you. OpioidRx analyzes pharmacy claims data to identify patterns that may signal physical dependence or withdrawal risk. When a concern arises, your plan works to connect you with the right support and resources.

How It Works

Step 01

Your Plan Monitors

Prescription patterns are reviewed to flag potential risk indicators — dosage, duration, and medication combinations.

Step 02

OpioidRx Identifies

Risk algorithms assess your prescription record against established clinical benchmarks to surface early warning signs.

Step 03

Your Team Connects You

If a concern is identified, your plan administrator or care coordinator follows up — not to limit care, but to make sure you have the right resources and support.

WHAT YOU CAN DO

Steps You Can Take Right Now

  • Talk to your doctor about dose and duration. Opioids are most effective — and safest — at the lowest dose needed for the shortest period necessary.
  • Keep a pain medication journal. Track your dosage, how often you take it, and its effects — both positive and negative.
  • Never stop abruptly. Work with your doctor on a tapering plan — unsupervised withdrawal can become medically serious.
  • Ask about a Treatment Agreement. A documented plan between you and your provider establishes shared goals for pain management and opioid use.
  • Know the 90-day threshold. If pain hasn't improved after 90 days of opioid therapy, co-management with a pain management specialist is a recommended next step.
KEEP THE CONVERSATION OPEN

Questions Worth Raising at Your Next Visit

"Can we document a treatment plan with specific goals for my pain management and opioid use?"
"Is Therapeutic Drug Screening appropriate for my situation — to confirm my medication is working at the right level?"
"Given how long I've been on this medication, would a pain management specialist be a helpful part of my care?"

Your care team wants to help. OpioidRx and your health plan are here to support that relationship — giving your providers better information so they can give you better care.

A SMARTER APPROACH

Aligned With CDC Best Practices

When your health plan works with OpioidRx, CDC guidelines become actionable — applied directly to your prescription record.

  • Right dose, right duration. Opioids are most effective — and safest — at the lowest dose needed for the shortest period of time.
  • Therapeutic drug screening. Monitoring confirms that medication is working as intended and identifies risk before it escalates.
  • Treatment agreements. A documented plan between patient and provider sets shared goals for pain management and opioid use.
  • Pain specialist referral. For pain that hasn't improved after 90 days on opioid therapy, a specialist consultation is recommended.
  • Dosing thresholds. Prescribing above 90 morphine milligram equivalents (MME) per day without specialist oversight carries measurably higher risk.

Content based on the CDC Clinical Practice Guideline for Prescribing Opioids, 2022. For informational purposes only. Always consult your healthcare provider.

Source: Portions of this content are based on materials developed by the Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services (HHS) — including the CDC Clinical Practice Guideline for Prescribing Opioids (2022), which is available at no charge at cdc.gov.

Use of CDC materials on this site does not imply endorsement by CDC, ATSDR, HHS, or the United States Government of OpioidRisks.org, Opioid Clinical Management Inc. (OPCM), OpioidRx, or any associated product, facility, service, or enterprise. Reference to specific commercial products, manufacturers, companies, or trademarks does not constitute endorsement or recommendation by the U.S. Government, HHS, or CDC.