The number of Ohio babies who come into the world sick and craving drugs continues to soar.

 New state reports show that the rate of neonatal abstinence syndrome — the medical term for withdrawal symptoms suffered by newborns — jumped to 159 per 10,000 live births in 2015.

That’s more than eight times the rate a decade earlier, in 2005, when there were just 19 such hospitalizations for every 10,000 live births.

“Given the way that the other numbers in the state are going, unfortunately, they were what I expected. I expected the NAS rate to go up,” said Rick Massatti of the Ohio Department of Mental Health and Addiction Services.

Ohio is awash in drug abuse and addiction, at times leading the nation in deaths from heroin and synthetic-opioid overdoses. And women who become pregnant while using drugs can double the harm if they don’t get help quickly.

But awareness and availability of treatment continue to lag.

“As a community, we are failing these moms by not having adequate treatment slots,” said Dr. Barry Halpern, an OhioHealth neonatologist who has helped lead local efforts to care for pregnant drug users and their infants.

– Rita Price
The Columbus Dispatch

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Prescription drug monitoring programs (PDMPs) are now active in most states to assist clinicians in identifying potential controlled drug misuse, diversion, or excessive prescribing. Little is still known about the ways in which they are incorporated into workflow and clinical decision making, what barriers continue to exist, and how clinicians are sharing PDMP results with their patients.

Design
Qualitative data were collected through online focus groups and telephone interviews.

Setting
Clinicians from pain management, emergency and family medicine, psychiatry/behavioral health, rehabilitation medicine, internal medicine and dentistry participated.

Patients
Thirty-five clinicians from nine states participated.

Methods
We conducted two online focus groups and seven telephone interviews. A multidisciplinary team then used a grounded theory approach coupled with an immersion–crystallization strategy for identifying key themes in the resulting transcripts.

Results
Some participants, mainly from pain clinics, reported checking the PDMP with every patient, every time. Others checked only for new patients, for new opioid prescriptions, or for patients for whom they suspected abuse. Participants described varied approaches to sharing PDMP information with patients, including openly discussing potential addiction or safety concerns, avoiding discussion altogether, and approaching discussion confrontationally. Participants described patient anger or denial as a common response and noted the role of patient satisfaction surveys as an influence on prescribing.

Conclusion
Routines for accessing PDMP data and how clinicians respond to it vary widely. As PDMP use becomes more widespread, it will be important to understand what approaches are most effective for identifying and addressing unsafe medication use.

Pain Medicine, Volume 15, Issue 7, July 2014 

A study was conducted to estimate the societal costs of prescription opioid abuse, dependence, and misuse in the United States. Costs were grouped into three categories: health care, workplace, and criminal justice.

The results: Total US societal costs of prescription opioid abuse were estimated at $55.7 billion in 2007 (USD in 2009). Workplace costs accounted for $25.6 billion, health care costs accounted for $25.0 billion, and criminal justice costs accounted for $5.1 billion. Workplace costs were driven by lost earnings from premature death ($11.2 billion) and reduced compensation/lost employment ($7.9 billion).

Conclusions: The costs of prescription opioid abuse represent a substantial and growing economic burden for the society. The increasing prevalence of abuse suggests an even greater societal burden in the future.

Pain Medicine, Volume 12, Issue 4, April 2011

David is Prescription Advisory’s Chief Marketing Officer. Software startups are his passion.

He also serves as the Director of Startup Grind Princeton and a mentor for the Princeton University eLab.

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