Pharmacy – Opioid
Opioids are often used to relieve pain after surgery or injury, or for major health issues like cancer. They can be an important part of your treatment. But they also come with serious risks.
Alameda Alliance Wellness is here to help you take charge of your health. You can use these guide to learn about other ways to treat and manage your pain without opioids. Always work with your doctor to find out which treatment is best for you.
Opioid Safety Guide for Patients & Caregivers
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Medicines for Opioid Dependence
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Manage Your Pain Without Opioids
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Prescription Management Safety Initiatives
Opioids are medications used to treat severe pain. Incorrect use can pose serious health risks. The Alliance Wellness, in collaboration with PerformRX (our pharmacy benefit manager), is implementing safety measures to help manage opioid use and ensure member safety.
When you take an opioid prescription to the pharmacy, safety checks may occur to confirm proper use. We may also contact you and your healthcare provider to share helpful information. To avoid delays in receiving your medication, we encourage you to discuss these safety measures with your doctor.
Summary of New and Expanded Opioid Safety Measures:
- Opioid and Benzodiazepine Use: The pharmacy will be notified when filling an opioid or benzodiazepine prescription.
- Duplicate Long-Acting Opioid: The pharmacy will be notified when filling multiple long-acting opioids.
- Multiple Pharmacies or Providers: Monitoring for prescriptions filled at different locations or by multiple providers.
- 7-Day Initial Fill Limit: Members new to opioids will be limited to a 7-day supply on their first fill.
- Refill Tolerance: Opioid prescriptions may only refill when 85% of the medication has been used (based on the prescribed day supply).
- Drug Management Program (DMP)
The Alliance Wellness Drug Management Program helps members safely use prescription opioids and other medications that may be frequently misused.
If we determine, in consultation with your healthcare providers, that your use of opioids or benzodiazepines may not be safe, we may place limits on how these medications are obtained.
Possible limitations may include:
- Requiring all prescriptions from a single pharmacy and/or provider
- Limiting the quantity of medications covered
- Restriction of combination of opioids and benzodiazepines
- If limitations are applied, you will receive a letter explaining the restrictions and have the opportunity to indicate your preferred doctor or pharmacy. If you disagree with our assessment, you or your doctor may file an appeal.
The DMP does not apply if you:
- Have cancer or sickle cell disease
- Are receiving hospice, palliative, or end-of-life care
- Are a resident of a long-term care (LTC) facility
- For questions, please contact PerformRx at 1.844.411.0579, 24 hours per day, 7 days a week.
Do you need more support? Please call
Alameda Alliance Wellness Member Services Department
Seven (7) days a week, 8 am – 8 pm, including holidays
Toll-Free: 1.888.88A.DSNP (1.888.882.3767)
People with hearing and speaking impairments (CRS/TTY): 711/1.800.735.2929