At Priority Health, we’re partnering with our health care providers to reduce opioid use among our local communities. Opioids are often overprescribed for acute pain and not always the best medicine for chronic pain. As a result, we’re asking doctors and pharmacists to limit the number of opioids prescribed, to reduce the amount of medication within each prescription fill, and to prescribe non-opioid alternatives for pain relief when possible. But we need your help, too, in order to end opioid dependency in our communities.

What is an opioid?

Opioids are a class of drugs used to reduce pain. This drug class includes the synthetic pain reliever Fentanyl, typically used for treating advanced cancer, and heroin, an illegal opioid. But it also includes commonly prescribed drugs that effectively treat moderate to severe pain but that come with serious risks and side effects including the possibility of death by overdose. Some of the most commonly prescribed opioids include:

  • Oxycodone (such as OxyContin®)
  • Hydrocodone (such as Vicodin®)
  • Morphine

Prescription drug benefit changes

As of Sept. 1, 2017, we made changes to prescription drug benefits that may impact you. We know these changes are not easy – in fact, you may be really upset. But we hope you understand the importance of these actions in keeping you and your loved ones safe.

  • prescription icon

    Short-acting opioids: Limited to a 15-day supply per fill and two fills every three months. For group and MyPriority members.

  • Doctor observing patient

    Long-acting opioids: Limited to a 30-day supply per fill. Applies to group and MyPriority members. 

  • Retail health clinic

    Maximum dose: 120 MEqD (morphine equivalent dose). Affects group, MyPriority and Medicaid members. Doses exceeding 120 MEqD require prior authorization. This means your doctor will have to contact us for approval before the prescription can be filled, which may take up to 72 hours.

  • Hands holding

    Palliative or hospice care: Members in palliative care or hospice and those with cancer are exempt from these prescription benefit changes.

Call us for help

If you or a family member has concerns about opioid dependency, or substance overuse or misuse, call 800.673.8043.

Our trained Behavioral Health team members will talk to you, assess your immediate needs and review your benefit eligibility for substance abuse treatment and/or medical management options, which include:

  • An inpatient detox program: You’ll be transferred to our clinical staff who will work quickly to get you immediate help.
  • A short-term, intensive residential treatment program: We’ll connect you with one in Michigan that is listed as a benefit in your plan and help determine how long you can stay. 
  • Outpatient behavioral health therapy and medical management: We’ll help you find resources and navigate your way through the system.

Help for overdoses

A medication called Naloxone, commonly known as Narcan, can help restore breathing in someone who has experienced an opioid overdose within the last 30-90 minutes. We recommend you fill a prescription and keep this medication on hand. Here's how you can get it:

  • Your doctor can prescribe it.
  • Your local pharmacy can provide it. A standing order from the State of Michigan means you don’t need a prescription, and many pharmacies can prescribe and fill prescriptions for Narcan upon request.

Your doctor or pharmacist can tell you how to use this medicine safely in the event you need to use it.

For any opioid overdose — even if you use Narcan — the affected person should immediately seek emergency care.

Additional resources

For more information about the opioid crisis and what Priority Health is doing to help solve it, visit ThinkHealth. 

If you’re dealing with not just substance abuse but additional health risks like chronic pain, you may wish to contact one of our care managers for help at 800.998.1037. You can also find resources in our Health Library