The Pennsylvania Board of Osteopathic Medicine refused Wednesday to let Thomas C. Barone, a pain management physician whose prescribing practices were linked to the deaths of four patients, return to his Center City practice. The decision continues a license...
DEA Ratchets Down Opioid Production The supply of almost every Schedule II opioid manufactured in the United States will be reduced 25% or more in 2017, as required by the Drug Enforcement Administration (DEA). The new quota will be sufficient to meet the estimated...
Drug Monitoring Program Records Significant Drop in Painkiller Prescriptions In the past year, the number of narcotic painkillers prescribed in New Hampshire decreased by more than 13 percent, while cases of suspected “doctor shopping” by patients dropped by nearly...
Ouch — common painkillers increase your risk of heart failure Yet another common painkiller could possibly kill you. Prescription-strength ibuprofen, naproxen and other anti-inflammatory drugs may raise your risk of heart failure almost 20%, according to a new BMJ...
Response to the Surgeon General’s Opioid Pledge: It Misses the Point Last week, the Academy of Integrative Pain Management (formerly the American Academy of Pain Management) held its 27th Annual Meeting, educating attendees on a broad range of non-pharmaceutical...
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
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
Doctors (and other clinicians) need to know what prescriptions have been given to their patients by other practitioners. This information should be included in the patients’ electronic health care records accessible through a Prescription Drug Monitoring Program (PDMP) that provides immediate information.
Presentation by the Dir., Div. of Epidemiology NIH, National Institute on Drug Abuse, May 2013
Effective monitoring systems [PDMPs] will augment clinical judgment, provide evidence of misuse, and facilitate prescription of the most appropriate analgesic for the situation…The Emergency Department is regarded as the nation’s safety net…the last bastion of around-the-clock access to care … Unfortunately, some of the solutions to opioid misuse [limiting ED physicians to 3-day opioid prescriptions] preempts judgments from trained emergency medical providers.
American College of Physicians, Annals of Internal Medicine, 9 April 2013
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
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
Attention to patterns of prescription requests and the prescribing of opioids as part of an ongoing relationship between a patient and a healthcare provider can decrease the risk of diversion. Periodic review of state PDMP, where available, is also a useful tool to monitor compliance. Evaluation should initially include…a drug history… Documentation is essential.
February 2013 American Academy of Pain Medicine
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
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.
Qualitative data were collected through online focus groups and telephone interviews.
Pain Medicine, Volume 15, Issue 7, July 2014
Prescribing or dispensing to an abuser, diverter, misuser or ‘doctor shopper’ puts the provider, their practice and or institution, as well as the patients at high risk.
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.
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