The Opioid epidemic continues to plague many individuals resulting in overdoses and in some cases death. According to the CDC, in 2020 almost 75% of drug overdoses were attributed to or involved an opioid. Opioid death rates  (which included individuals prescribed and not prescribed medications) increased from 2019 to 2020.[1] Those actively battling withdrawal often experience a host of side effects.

Opioid Withdrawal

Individuals experiencing withdrawal symptoms may suffer from muscle aches, restlessness, anxiety, lacrimation, runny nose, excessive sweating, inability to sleep, yawning often, diarrhea, abdominal cramping, goosebumps, nausea, vomiting and more. The National Institute of Health’s (NIH) Director’s blog noted a small study that the drug suvorexant (Belsomra ®) provided some relief for specifically insomnia as well as just overall withdrawal symptoms.[2] 

What is Suvorexant?

Suvorexant is an FDA approved drug categorized as a Class IV or Schedule IV that is used to treat insomnia.   There are 4 different dosages available: 5 mg tablets, 10 mg tablets, 15 mg tablets and 20 mg tablets. The manufacturer (Merck) recommends that patients are prescribed the lowest effective dose. Studies have not been able to show that suvorexant is effective in pediatric patients.[3] 

What to look for?

While the one study referenced above noted that those overcoming opioid addiction and experiencing withdrawals may benefit from suvorexant, the study was small and more research is likely needed. Therefore, it is recommended that any prescriptions for suvorexant for patients that do not have a documented history of insomnia and are being treat for opioid use or addiction be reviewed in greater detail. Look for NDCs 00006-0005-30, 00006-0033-30, 00006-0325-30, 00006-0355-30.

Healthcare Fraud Shield Alerts

As an example, Healthcare Fraud Shield created the following alert to assist our clients in monitoring this prescribing behavior:

[5233-01] – OFF-LABEL USE OF SUVOREXANT, (BELSOMRA): This Alert identifies NDCs for Suvorexant (Belsomra) are billed without a supporting diagnosis of insomnia.

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