As the nation’s opioid crisis worsens, the authorities are confronting a resurgent, unruly player in the illicit trade of the deadly drugs, one that threatens to be even more formidable than the cartels.

The internet.

In a growing number of arrests and overdoses, law enforcement officials say, the drugs are being bought online. Internet sales have allowed powerful synthetic opioids such as fentanyl — the fastest-growing cause of overdoses nationwide — to reach living rooms in nearly every region of the country, as they arrive in small packages in the mail.

The authorities have been frustrated in their efforts to crack down on the trade because these sites generally exist on the so-called dark web, where buyers can visit anonymously using special browsers and make purchases with virtual currencies like Bitcoin.

Follow Prescription Advisory

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
  • pharmacist-assisted rounds
  • 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 prescription drugs and nonmedical users.

American Psychological Association

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 information provided had an important impact.

ACEP - Annals of Emergency Medicine – 525
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