Every day in the news we hear about the devastating impact of the opioid crisis across the country. While we need to confront this complicated crisis, we also need to examine the larger issue of substance use disorders (SUD) that impact millions of Americans.

This past September, I had the honor to represent Magellan Health at the first meeting of the Substance Use Disorder Treatment Task Force, founded by Shatterproof. The mission of the task force is, “To fundamentally improve substance use disorder treatment in the United States, in terms of both quality and patient outcomes.” It also addresses the underlying cause of our country’s current substance use crisis, and lack of access to quality and evidence-based treatment. The task force has been created to expand access to quality treatment for the estimated 21 million Americans with SUD.

This task force is unique in that it convenes public and private healthcare companies, advocates and former government officials to take the lead in developing a tactical plan with measurable goals for payers to follow and implement. I am proud to be joined by so many colleagues and experts across the industry.

Our first focus is to implement the recommendations outlined in the November 2016 Surgeon General’s Report on Alcohol, Drugs, and Health. Secondly, we will utilize methods outlined in a 2006 report from the Institute of Medicine which recommends the need for a group of government regulators, accrediting organizations, consumer representatives, providers and purchasers to come together to develop a common, continually improving set of quality measures, specifically for mental health and substance use disorders.

The work of this task force aligns nicely with our efforts at Magellan, helping lead individuals to healthy, vibrant lives. Working with individuals with SUD, from both the behavioral health and the pharmacy benefits management perspective, we are in a unique position to help address these issues. I believe we can make significant contributions on this task force and for the benefit of our customers, members and providers with whom we work.

During National Depression Awareness Month, we wanted to take some time to discuss the very normal stress and mental health challenges working families experience as we are increasingly connected to our jobs. As our connectivity to work has grown – between email, texting, chats, phone calls, video conferencing calls, and a myriad of social networking sites – so has the challenge to separate work from our personal lives. Employees are spending an increasing amount of time both at work and thinking about work. Habits such as checking email during a family dinner or ruminating about that email that you’d forgotten to write in bed at night are common experiences for many. Add on top of that a child who’s acting out and a parent who needs a little extra care both physically and financially, and you have a recipe for stress that affects your own health and mindset, as well as potentially relationships with family, friends or colleagues.

Employee assistance programs (EAPs) have been adopted by many employers to reduce the impact of mental health disorders, workplace stress and other work/life issues on workplace productivity. Despite the ubiquity of this employee benefit, which is offered by 97 percent of large employers, utilization hovers around five percent industry-wide. A primary barrier is the stigma of utilizing EAP programs, which were historically grown from occupational substance abuse programs.

While great strides have been made in reducing stigma, a great opportunity lies in changing the premise that stands in the way of employees tapping into services that might help them move forward and find their best self. What if we were to fundamentally remove the premise that there are people with “issues” and people without? The reality is that every employee is faced with their own brand of “juggle,” and stress and anxiety continue to be on the rise as working families live increasingly busy lives.

As Magellan transforms the EAP benefit for modern day workers and their families, we’re driven to provide resources and tools to help people address their mental health challenges before they severely impact their lives and productivity. The pivot lies in helping employees take care of their mental health as a practice of self-improvement and in helping employers position EAP services in their culture of well-being.

There are three essential components to powering this shift in the transformed EAP:

• Clinically-validated online programs and mobile apps that help employees track and change habits and mindsets
• When employees experience a bump in the road, convenient access to a coach or therapist that can fit into their harried day
• Content that inspires, motivates and helps employees feel validated in the normalcy of their stress and feel connected to others tackling similar experiences

Imagine a world where employees give each other a high five for taking some “me” time, leveraging a convenient method of choice, just as they do for someone sticking to their gym routine or running their first 5k. We certainly do!

“We are often asked in interviews what our most memorable experience has been as a pharmacist,” said Marc. “I used to have a go-to story I thought was amazing, but now that story has been replaced.”
Marc Ream
Clinical Pharmacist, Magellan Rx

This month, we’re celebrating our amazing pharmacists and the work they do to impact members at virtually every point along the patient-care continuum. Today we’re sharing a story from clinical pharmacist Marc Ream, who partnered with the commercial pharmacy team to go above and beyond the call of duty for a family in need.

Although he did not know it then, when Marc Ream took a call late on a Friday afternoon, he was about to experience what would become the most rewarding moment in his career as a pharmacist.

The call came from a mother with an urgent request for an oncology drug approval for her 10-year-old daughter, Jane.* Jane, who lives with Leukemia, needed a specific medication that is relatively rare and not easily accessible. The family was leaving on their long-awaited vacation the next day, so they needed the medication that same day. Marc quickly realized that  getting this medication to the member quickly would require collaboration with the prescribing oncologist, as well as with multiple parties including the health plan, account managers, technicians, pharmacists, physicians and the dispensing pharmacy.

Marc quickly went to work, placing a call to the prescribing oncologist to gather a comprehensive history on the young girl, as well as the necessary clinical rationale to make the approval. Typically, once a medication is clinically approved, the pharmacist’s job is complete and the prescription can be filled by a local pharmacy. However, this particular oncology drug was classified as a limited-distribution medication, typically dispensed only through mail-order facilities. Realizing that the family would not have time to wait, Marc contacted a specialty pharmacy in the area to try to come up with a quicker solution.

He reached out to the pharmacy’s lead oncology pharmacist and confirmed that the medication was in stock, and they conferenced in Jane’s physician to place the order.  Marc worked with the oncology pharmacist to schedule delivery of the medication to the family. When they called the mother to tell her the good news, they could hear the emotion and gratitude in her voice. Thanks to the swift and diligent work of many, Jane and her family were off on their dream vacation with this important medication in hand.

Thank you to Marc Ream and the commercial pharmacy team for this empowering story that shows just how passionate and committed we are to leading humanity to healthy, more vibrant lives.

*Details around the specific circumstances of this story have been changed to protect the identities of both Jane (not her real name) and her family.

Today, children and adolescents with behavioral health challenges are generally prescribed, and use, an alarming number of psychotropic medications. This excessive usage has raised concerns among families, practitioners and advocates amid questions about the appropriateness of the diagnoses that justify the drugs’ use – as well as the uncertainty surrounding the long-term effects of these drugs on a child’s neurological development.

Thinking ahead about the challenge

Magellan Health has had its eye on this issue for years, publishing a popular monograph, “Appropriate Use of Psychotropic Drugs in Children and Adolescents,” on the topic in 2013, which addressed the anxiety and confusion around the issue. Now – leveraging new data and research – we have released an updated monograph.

We know that appropriate use of psychotropic medications can play a role in helping children and youth with behavioral health conditions successfully live at home, achieve in school and experience positive engagement within their communities. But first parents, caregivers and practitioners need to fully understand the risks and monitor their use. When they’re used in the wrong way, these drugs can lead to a host of medical conditions and social problems that prevent youth and their families from achieving their goals.

10 questions to ask before starting treatment

To tackle this issue in the most practical way, we’ve developed a list of top 10 questions for caregivers, practitioners and the child/youth to discuss before beginning this type of treatment:

The treatment options

1. Are these medications needed?
2. Will the child benefit from therapy?
3. Did the child get a full evaluation from a behavioral health practitioner?

The medication

4. Has the medication been tested and approved for children? What are the risks, benefits and side effects?

The treatment plan

5. How will we know the child is making progress?
6. How often will the child be checked after starting the medications? What happens if we don’t see progress?
7. What warning signs should we look for and when should the doctor be called?
8. Will the treatment be noted in the child’s health care records?
9. Will the practitioner talk to the child’s other health care providers?
10. Does the practitioner know of other medications the child is taking and are there risks in combining them?

Implications

We know practitioners strive to do the right thing for the individuals they serve. With our monograph, we aim to support them in their decision-making process. Our approach is to help primary and behavioral health practitioners – as well as parents, youth and advocacy organizations – make informed decisions that most effectively meet each child’s needs. When the right medications are prescribed and monitored, they can have positive results in a child’s life.

Magellan’s own CTO, Srini Koushik, was recently featured in Forbes Insights, talking about the benefits of videoconferencing and how it is changing the way that we work at Magellan. In the article, Srini discusses how new technology is improving efficiency while increasing connectedness and effectiveness of teams.

Check Srini’s profile here.

Earlier this year, Srini shared his experiences reimagining Magellan as a digital healthcare company here on the Magellan Health Insights blog. Take a look at his views here.

Contemplating life and death is probably common when in the midst of a natural disaster. As the eye of Irma passed over me on September 10, I was thinking about suicide and suicide prevention. September is Suicide Prevention Awareness Month, and Magellan Complete Care, our health plan for individuals living with serious mental illness in Florida, had been busy preparing for summits to draw attention to and dialogue around suicide prevention to local communities. Two days before Irma hit, I was busy canceling vendors for the summits. The day before Irma, I was dealing with a surprise, last-minute mandatory evacuation order while trying to locate a friend who was experiencing homelessness and depression, and who had expressed a desire to let the storm take his life instead of seeking shelter.

As the winds howled, windows rattled, and rain pounded against the home I had evacuated to, I sat on a closet floor thinking about how much I wanted to live and how that desire to live had not always been there. There were years where, like my friend, I was lost in my own storm. Depression had flooded my soul, my thoughts were battered by negativity and I never felt safe. The aftermath, similar to a hurricane, was a life left in shambles, just wishing for normalcy.

Recent hurricanes, earthquakes and wildfires remind us of the value of life. Suicide Prevention Awareness Month provides another reminder. Every 13 minutes that the winds and rain of Irma pelted my home state, someone in this country was ending their life too soon by suicide. With a completed suicide happening in Florida every three hours , the death toll from suicide may end up being higher than that from Irma’s destruction.

Natural disasters and the realities of suicide provide the same call to action to communities. We have a responsibility to watch out for each other and take care of each other. When the power is out, you share the food and batteries you have and a reminder to hold on. When someone’s internal light is out, you share hope and support and a reminder to stay strong.

There is much work ahead to rebuild lives, homes, and communities devastated by recent natural disasters; to support communities in reducing death by suicide; and to help individuals struggling through adversity. I am living proof that a life can be rebuilt. Whatever challenge you are facing, hold on, stay strong and don’t be afraid to ask for and accept help.

A study by a team of Magellan researchers, demonstrating the pervasiveness of opioid addiction, was featured on CBS Philly (KYW).

The study, an analysis of medical and pharmacy data from 2009—2012 for 2.5 million people aged 20-64 who were part of a commercial health plan, showed that 48 percent of patients who had stopped using opioids for at least six months went on to use them again.

You can read more about the study by clicking here.

Written by Thomas Lane, NCPS, CRPS

September is National Recovery Month, and during this time, we celebrate the fact that people living with mental health and substance use disorders can and do recover.  Recovery is real.  But what does it mean to recover?  It’s an important question, and there is no simple answer.  Each individual experiences recovery in unique ways.  As a person in recovery, here is what I believe we have in common.

Hope – We all need hope in our lives.  Hope is like a beacon, a light that shines in our lives and in the lives of others.  It is vital.  But there are times when we lose hope.  It’s in those times we need someone to hold the hope for us.  Hope doesn’t cost anything to give, yet it is priceless.

Self-determination – Self-determination is a fundamental value in our lives. For many of us, our choices have been limited due to the impact of our mental health or substance use disorders.  Some of us live with both.  There are times when conditions are imposed on us that are not consistent with our own goals and aspirations.  Self-determination is so important, because without it, we can feel hopeless and without control in our lives.  Decision support tools and opportunities to strengthen self-efficacy empower us to choose self-determined roles in communities of our choice.

Connectedness – We are interdependent.  Connections to others and meaningful relationships are human needs.  Without connections, we can feel isolated. Developing circles of support and being included strengthens our recovery.  We are part of our communities and cultures, not separate from them.

Health  – Many of us live with chronic health conditions.  In fact, the average life expectancy for a person living with a serious mental health condition is twenty five years shorter than the general population. Finding good health care professionals who support improvements in our health and conditions, beyond just symptom and illness management, helps us realize improved personal health outcomes.   We develop healthy living habits.  Good nutrition, exercise, restful sleep; we are intentional in our approach to live well.

Peer Support – To me, peer support is the bedrock for recovery.  When someone shares experiences we can relate to, experiences we may have in common, we discover we are not alone.  We discover others have made it through similar difficult times and overcome similar challenges.  We are encouraged.  We gain confidence.  We rediscover hope.  And we pay it forward.

As I think about this year’s National Recovery Month, I know from my own experience that recovery is not a straight path.  I know there may be setbacks and hurdles to overcome.  But I am absolutely convinced that recovery is real.  It happens when we have hope in our lives, when we have choices, and when we are connected to each other and our communities.   It happens when our health care needs are met and we work to become healthier.  For so many of us, peer support represents the beginning of our journey.  Let us celebrate each person’s pathway, honor each person’s journey, and welcome those who walk alongside us.