PDMP & Opioid Abuse News
PDMP & Opioid Abuse News
- Nada to work with police to tackle drug abuse in hotspot schools 20 Aug 2017 09:03 New Straits Times TANAH MERAH: The National Anti-Drugs Agency (Nada) will co-operate with other agencies, such as the police and Education Department, in combating drug abuse among students in 31 hotspot secondary schools in the country. Its director-general, Datuk Dr Abd …
- The problem of drug abuse in India 20 Aug 2017 06:41 MeriNews A healthy nation denotes for its healthy people. When people get addicted to vices like drugs, prostitution, alcoholic drinks, betting and gambling, etc, its ruining impact does not limit to the consumer or his / her family and the society but also …
- Detoxing no solution on opioids 20 Aug 2017 06:24 The Journal Gazette “I'm detoxing.” This is the sort of news that delights the families of patients who are addicted to heroin. The promise of a seven-day detox solution is seductive. But detoxification is actually extremely dangerous. Nearly every addict who …
- New Haven pharmacists take fight against opioids to the streets 20 Aug 2017 05:22 New Haven Register Pharmacists take fight against opioids to the streets By Ed Stannard, estannard@nhregister.com @EdStannardNHR on Twitter Published 8:28 pm, Saturday, August 19, 2017 Photo: Arnold Gold / Hearst Connecticut Media Ed Funaro Jr., director of Visels …
- More than 100 participate in Ride Against Opioids 19 Aug 2017 21:25 Washington Times BRENTWOOD, N.H. (AP) - More than 100 people have participated in a charitable motorcycle ride to help fight New Hampshire’s opioid crisis. WMUR-TV reports (http://bit.ly/2v2562U ) the Ride Against Opioids Saturday in Brentwood was held in …
- Opioids: Politicians Should Not Play Doctor 19 Aug 2017 19:10 National Review Back in January 2013 I put up a post over on Ricochet on moves to cut access to prescription painkillers by then Mayor Bloomberg and the rather better qualified FDA. As the New York Times reported, the FDA explained (my emphasis added): Trying to stem the …
- Docs Criticize Move by Top Drug Middleman to Limit Opioids 19 Aug 2017 04:13 NBC Philadelphia The nation's largest pharmacy benefit manager will soon limit the number and strength of opioid drugs prescribed to first-time users as part of a wide-ranging effort to curb an epidemic affecting millions of Americans. But the new program from Express …
- At the centre of Toronto's opioids crisis, an unexpected view: DiManno 18 Aug 2017 22:20 The Star They are nice people, well-known in the neighbourhood. Many stop to say hello. “His sweetie,” says Austin to a street friend. Several inquire about the IV. “My foot got infected,” Smith explains. Unlike many of their acquaintances, Smith and Austin aren’t …
- Correction: Opioid Abuse story 18 Aug 2017 21:16 Boston Herald BOSTON — In a story Aug. 16 about nonfatal overdoses, The Associated Press, relying on information provided by Gov. Charlie Baker's office, reported erroneously the period for which the number of such overdoses surpassed 65,000. The period in question …
- Opioids epidemic may hurt chronic pain patients 18 Aug 2017 21:03 Connecttristates.com BAKERSFIELD, Calif. (KBAK/KBFX) — The opioids commission President Donald Trump assembled is now suggesting the president declare a national emergency on the drugs. Tighter restrictions may hurt people with legitimate prescriptions for real pain. …
Follow Prescription Advisory
The CDC advises providers to use PDMPs… States should consider ways to increase their use … available real-time, and alerts to prescribers.
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
In 2012, both New York and Tennessee required prescribers to check their state’s PDMP before prescribing painkillers.
The results one year later:
New York realized a 75% drop and Tennessee a 36% drop in patients who were seeing multiple prescribers to obtain the same drugs.
You’re not only reducing the supply [of pain medications] for those who use them inappropriately, but also for those in need.
The use of PDMPs…is helping to reduce misuse of prescription drugs.
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.
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.
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.
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.
PDMPs have many limitations in their current format, including complex access issues, timeliness, and whether the data are presented to the physician automatically or require physician effort to retrieve.
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.
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 costs were driven by lost earnings from premature death ($11.2 billion) and reduced compensation/lost employment ($7.9 billion).
Conclusions: The costs of prescription opioid abuse represent a substantial and growing economic burden for the society. The increasing prevalence of abuse suggests an even greater societal burden in the future.
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.
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.
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.
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
You’re not only reducing the supply [of pain medications] for those who use them inappropriately, but also for those in need.
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.
The CDC advises providers to use PDMPs… States should consider ways to increase their use … available real-time, and alerts to prescribers.
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.