In the process of reporting on the nationwide opioid crisis, there’s one common refrain that surfaces in conversations more than any other: “We aren’t going to arrest our way out of this problem.”

But, while there is overall consensus that the criminalization of drug use isn’t the right tactic to use, there is much less unity in identifying other approaches that state and local governments can take.

Richard Leadbeater, a state government industry manager at Esri, the Redlands, California-based geographic information systems software company has one idea: “To be honest, the best ammunition that public officials can embrace is storytelling.”

And, for Leadbeater, that storytelling comes in the form of data and maps.

– Quinn Libson
Staff Correspondent
Route Fifty

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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 

Whenever possible, orthopaedic surgeons should request and review old medical records and speak with the patient’s primary physician about past medication problems. Currently, states have Prescription Drug Monitoring Programs designed to assist law enforcement in the identification of doctor shoppers; these data are also accessible to physicians.

American Academy of Orthopaedic Surgeons, Now, March 2014

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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