Medscape’s Robert Lowes recently published an article detailing opioids’ prominent role in medication malpractice claims. Much of the press around the opioid crisis covers the deaths, hospitalizations, and substance use disorder problems. All of these can...
Route 50 talks about the importance of maps in telling the story of the opioid epidemic and how it can help public officials in particular drive home the point. Sometimes a picture is worth far more than 1,000 words. One of the challenges I see is the huge amount of...
Here is an example of the Board of Medical Examiners using PDMP history in the complaint process resulting in the practice shutting down. The record of PDMP checks is there, and a few states are starting to look at their mandated use requirements and the gaps between...
BMJ recently published an analysis of opioid prescribing among Medicare patients -“Opioid prescribering by multiple providers in Medicare: retrospective observational study of insurance claims”. A couple of things jumped out: Just over two thirds of opioid...
Dr. Vivek H. Murthy, our Surgeon General, recently released a report that, among other things, highlights the gap between the widespread substance use disorder problems the country faces and the relatively small amount of abuse treatment. Here’s an excerpt from...
Governor Chris Christie signed a bill on July 20th, 2015 requiring drug prescribers and pharmacists in NJ to register for the state’s Prescription Monitoring Program (PMP) and to check the PMP when prescribing controlled substances. “We’re not only...
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
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
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
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
Recommendations for full use of PDMP include:
PDMPs can be effective clinical tools in medication management involving controlled substances.
PDMPs should be available for clinicians across state boundaries.
Every prescribing clinician should be familiar with the process of accessing and utilizing information from PDMP’s so that they can incorporate this information in their practices.
American Society of Addiction Medicine
The use of PDMPs…is helping to reduce misuse of prescription drugs.
PDMP Center of Excellence at Brandeis University, February 2014 Briefing
The CDC advises providers to use PDMPs… States should consider ways to increase their use … available real-time, and alerts to prescribers.
Center for Disease Control and Prevention
Emergency Physicians must balance under-treatment of pain with concerns about drug diversion and doctor shopping. Use of a state PDMP may help identify patients who are at high risk for prescription opioid 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%. Knowledge of the i…
ACEP - Annals of Emergency Medicine – 525
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