Dublin-based healthcare giant Cardinal Health on Friday agreed to pay $44 million to settle multiple lawsuits regarding the distribution of various controlled substances. Cardinal Health admitted that it failed to report large orders for powerful painkillers like...
2016’s Top 5 Advances in Primary Care Opioid crisis and what to do about it tops list MedPage Today asked specialists in primary care around the country to tell us what they thought were the most important clinical developments in 2016. These were the five most...
The Staggering Costs, Monetary and Otherwise, of Substance Abuse A new report from the Surgeon General says the country spends $442 billion a year in dealing with drug and alcohol abuse. There are so many issues dividing America right now. But there is a terrible...
Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015 The U.S. opioid epidemic is continuing, and drug overdose deaths nearly tripled during 1999–2014. Among 47,055 drug overdose deaths that occurred in 2014 in the United States, 28,647...
More states urged to mandate physician use of prescription drug monitoring databases As the number of drug overdose deaths linked to prescription painkillers continues to rise, experts are calling on more states to set mandates requiring prescribers to check state...
Use of a state PDMP may help identify patients who are at high risk for diversion or doctor shopping… To quantify the effects of PDMPs, studies were conducted of ED providers who cared for adult patients with pain. Of the patients with complete data in one study, information from the state’s PDMP System altered prescribing practice in 41%.
ACEP - Annals of Emergency Medicine - 525
The AAOS recommends the following tools, which have been shown to significantly reduce medication errors:
computerized physician order entry
computerized decision support systems
computerized monitoring of adverse drug events
high-risk drug protocols
Overdose deaths are “just the tip of the iceberg”: that for every death there are many more hospital treatment admissions, emergency room visits, people who abuse or are dependent on prescripti…
American Psychological Association
What prescribers can do to safely and effectively use opioids for CNCP (includes the following)
Screen for prior or current substance abuse/misuse
Do not use concomitant sedative–hypnotics or benzodiazepines
Track daily MED using an online dosing calculator
Use the state Prescription Drug Monitoring Program to monitor all sources of controlled substances
Neurology, 2014; 83; 1277-1284, September 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
When a clinician is prescribing a controlled substance, readily available information about the drugs that a patient is receiving from other providers can be a critically important component of the decision-making process…Increasingly, these [PDMP] programs have evolved into a useful tool for the clinician who must incorporate careful risk management into the prescribing of opioid analgesics or any other controlled substance.
Increasingly, these programs have evolved into a useful tool f…
Editorial Pain Medicine, The American Academy of Pain Medicine; 2011;12:845
You’re not only reducing the supply [of pain medications] for those who use them inappropriately, but also for those in need.
Bob Tillman – Director of Policy and AdvocacyAmerican Academy of Pain Management
Thirteen multi-state PDMP projects were sponsored in 2012-13. While providers indicated that PDMPs gave them more confidence for prescribing pain medication, the study concluded that the easier the data is to obtain, the more they will be used, and the safer the practice can be.
Substance Abuse & Mental Health Services AdministrationOffice of the National Coordinator for Health IT, & MITRE Corp
Although relieving pain and reducing suffering are primary emergency physician responsibilities, there is a concurrent duty to limit the personal and societal harm that can result from prescription drug misuse and abuse.
Pain Management / Clinical PolicyACEP Annals of Emergency Medicine 525, October 2012
Always check the medical record… and a prescription drug monitoring database.
Federation of State Medical Boards
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…
Pain Medicine, Volume 12, Issue 4, April 2011
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