Dr. Anuradha Rao-Patel discusses the opioid epidemic


Dr. Anu, thank you so
much for sitting down to talk with us about this
important and very timely topic– the opioid epidemic. Thank you for having me, Laura. Let’s start at the top– the most simple of questions. What is an opioid? And why are they so addictive? So an opioid is a class of
drugs that’s used to treat pain. One of the ways that
opioid addiction occurs is the way that our body
actually metabolizes the drug. When this happens, our
brain releases dopamine, which is a neurotransmitter. So in addition to the effect
of getting pain relief, sometimes we get a
positive reinforcement, such as a feeling of
euphoria or pleasure. After time, as you
can imagine, this is not the normal state
for our body to be in. So our body tries to return
back to its baseline level. So we end up needing
more of the same drug to get the same effect,
whether it’s euphoria or whether it’s pain relief. And then when does
too much turn deadly? Too much can turn deadly,
unfortunately, very quickly. The way that we end up dying
from an opioid overdose is because it triggers
that part in our body that causes us to
breathe normally. And it in effect causes
us to stop breathing. Or usually patients die
from respiratory depression. We know this is a huge
problem all over the country. North Carolina has been
hit especially hard by this epidemic. How big of a problem
is it in our state? So that’s exactly right. It’s a huge problem
within our state. We actually have
four cities that have been hit the highest by
opioid addiction and death in the entire nation. Why are you so passionate
about this issue? So Laura, prior to
joining Blue Cross North Carolina three years ago,
I was actually in practice doing pain management
and addiction medicine. So I was able to see
firsthand how this affected patients and their families. I recall fondly an older
patient that I had. She kept her appointments. She never talked about
lost prescriptions. But after a year of seeing
me, she talked to me and said that she felt
like she had a problem. And she had been getting
pain medicines from both me and her primary care physician. It’s not just young
people anymore who are being addicted
to these medications. We see grandmothers. We see crosses across
socioeconomic classes, different education levels. Anybody can be
affected by addiction. So here at Blue
Cross North Carolina, what are we doing to
help fight this epidemic? At Blue Cross North
Carolina, we’re approaching this from
a three-prong approach from prevention,
intervention, and treatment. We’ve done a lot of
things internally within our plan– for
example, provider education and outreach,
engaging our members. We have pharmacy initiatives
that we’ve put in place. We’ve even been
to the White House and testified at the
President’s Commission. So if there’s
someone watching who thinks they may
have a problem, we want them to know that we
have resources here, right? How can we help? Yes, exactly. We have a tremendous
amount of resources here at Blue Cross
North Carolina. We have case management. We have nurses. We have medical directors
here at the plan. And we have a partnership
with Walgreens Pharmacy across the state. So we have drug take-back boxes
in select Walgreens stores across the state
where patients can return their unused and
unwanted medications. And this is kind of the stuff–
we don’t want this getting in our water system either. So what would you tell people
about flushing these types of medications down the toilet? Yeah, actually that’s not
the most recommended way to get rid of these
medications as you can imagine. I would encourage
them, again, if they don’t want to come
to a Walgreens or if there isn’t a Walgreens
close to where they are, there are drug take-back
boxes in all law enforcement offices across the
state of North Carolina. I think the important thing is
to get them out of their homes and off their medicine cabinets. Let’s say a member is going
in for a joint replacement. What do they need to know and
be aware of before that even happens? I think having a conversation
with your provider and understanding what
the expectations are after surgery– that it’s normal to experience
a certain amount of pain and to really look for
alternatives besides opioids to deal with this pain. That’s right. You don’t have to accept
opioids as the solution. What other
alternatives are there? In some situations, opioids
are certainly the answer. But in many situations,
they’re actually not. So we do have other medications
that physicians can try, which are not opioids
but will help with pain. There are also other things
your provider can refer you to– things like
physical therapy or aquatic therapy,
chiropractic care. Those are things that we
actually do cover here at Blue Cross North Carolina. And we don’t even require a
prior authorization for them. Dr. Anu, thank
you for your time. And hopefully this will
spark more conversations and more awareness as we work
to address this epidemic. Absolutely. Thank you. Thanks. [MUSIC PLAYING]

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