CLINICAL PARTNERSHIP PROGRAM

Supporting Better Outcomes for Patients on Long-Term Opioid Therapy

A CDC-aligned risk management program, in partnership with your patients' health plan. This information is prepared for clinicians whose patients are enrolled in a health plan that has partnered with OpioidRx.

ABOUT THE PROGRAM

A Partnership Designed to Support, Not Supplant, Your Clinical Judgment

Your patients' health plan has engaged OpioidRx to identify prescription patterns that may indicate elevated risk for opioid dependence or misuse — and to support alignment with CDC best practice guidelines. When a concern is identified, clinical specialists working on the plan's behalf may reach out confidentially to share relevant information and support guideline-aligned care.

This is not a utilization management function. It is a clinical support program — one that treats your expertise as central to the outcome.

What This Looks Like in Practice

Risk Identification

Pharmacy claims data is analyzed continuously to identify members with high-risk opioid prescription patterns — including dosage, duration, co-prescribing, and MME thresholds.

Clinical Outreach

OPCM clinical pharmacists — each with over 20 years of retail pharmacy experience — may reach out to potentially affected prescribers to share data-informed context and discuss CDC guideline alignment.

Supported Adjustment

Where appropriate, interventions may include therapeutic drug screening, opioid treatment agreements, or specialist co-management referrals — always in collaboration with the treating clinician.

Dosing and Duration. Prescribe the lowest effective dose for the shortest clinically appropriate period. Avoid initiating treatment at doses ≥50 MME/day; exercise particular caution above 90 MME/day.
Therapeutic Drug Screening. Drug screening supports objective confirmation of medication adherence and detection of undisclosed co-use — improving the accuracy of clinical decision-making for both patient and provider.
Opioid Treatment Agreements. Documented agreements establish shared goals for pain management, define expectations around use, and create a structured framework for monitoring and adjustment.
Chronic vs. Acute Distinction. Patients on opioid therapy for more than 90 days without documented functional improvement represent a distinct clinical cohort for whom re-evaluation and specialist consultation are recommended.
Co-prescribing Awareness. Concurrent prescribing of opioids with benzodiazepines, antidepressants, or antipsychotics represents a compounding risk signal that warrants close monitoring.

CDC Clinical Practice Guideline for Prescribing Opioids — United States, 2022. MMWR Recomm Rep. 2022;71(3):1–95.

"Rate of provider adherence to each CDC guideline for opioid prescribing increases by at least 75% after first OPCM contact."

— TPA Case Study, OPCM Internal Data (n=928, p=0.00e+00)

Downstream Utilization — Florida County School District 12-month cohort

Measure	Reduction
Emergency department visits	↓ 37%
Outpatient physician visits	↓ 41%
Inpatient hospitalizations	↓ 39%

Data sourced from OPCM Evidence-Based Reports. Full reports available upon request.

For Primary Care Clinicians

OpioidRx surfaces early risk indicators from claims data that may not be visible within a single clinical encounter — supporting treatment agreements, drug screening, and duration-appropriate prescribing without adding administrative burden to your workflow.

For Pain Management Specialists

OpioidRx provides a longitudinal claims-based view of prescription patterns across the full care network — including prescriptions issued outside your practice — supporting more accurate MME calculation, co-prescribing risk assessment, and tapering decisions grounded in the patient's complete opioid history.

Opioid Treatment Agreements — Documented goals and expectations consistent with CDC guideline recommendations
Therapeutic Drug Screening — Objective confirmation of adherence and co-use detection
Duration Benchmarking — Structured re-evaluation triggers at the 90-day threshold
Specialist Co-management — Identification of patients for whom pain specialist engagement is clinically warranted

IMPORTANT CLARIFICATION

OpioidRx is not a utilization management or prior authorization program. It does not restrict prescribing, deny claims, or generate automated alerts to patients. Its purpose is to provide clinical context and support evidence-based conversations — between your practice and your patients' care team.

Adoption of CDC Guidelines — Policy Statement MME Dose Calculator Pocket Guide to Tapering Opioids Surgeon General's Statement Pain Management Contract 1 Pain Management Contract 2 Pain Management Contract 3

CDC Clinical Practice Guideline

The CDC's Clinical Practice Guideline for Prescribing Opioids provides evidence-based recommendations to help clinicians balance effective pain management with patient safety.

View CDC Guideline →

State Prescription Drug Monitoring Programs

Prescription Drug Monitoring Programs (PDMPs) are state-level databases tracking controlled substance prescriptions. Access your state's PDMP below.

View State PDMPs →

For clinical reference only. OpioidRx does not direct patient care. All treatment decisions remain at the discretion of the prescribing clinician.

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.