States need to do a better job utilizing prescription drug monitoring programs (PDMPs) to help battle a worsening epidemic of fatal overdoses caused by painkillers, according to a new report from Brandeis University.
Forty-one states have PDMP’s that gather information from physicians and pharmacies to track prescriptions for controlled substances such as painkillers and anti-anxiety medications. The goal is to prevent the misuse, abuse and diversion of the drugs.
Researchers at Brandeis University’s Heller School for Social Policy and Management assessed the various drug monitoring programs and found a patchwork of strategies and standards. They recommend that states do a better job analyzing the data they collect and shift from a reactive to a proactive approach.
“Being proactive is the key to success in the fight against prescription painkiller abuse,” said John Eadie, Director of the Prescription Drug Monitoring Program Center of Excellence at Brandeis. “While doctors may routinely collect and report data to a state program that signals where and when prescription painkillers are likely being misused, the program might not share that information with others who can best use it.”
Researchers found that states with PDMPs that collected information on all controlled substances had lower rates of doctor-shopping – where a patient goes from doctor to doctor to obtain prescriptions. Doctor-shopping also declined when physicians and pharmacists were proactively sent alerts about possible abuse.
“Good things happen when state prescription drug monitoring programs shift to a proactive strategy,” said Dr. Nathaniel Katz, assistant professor of anesthesia at Tufts University School of Medicine. “Not only can it prevent painkillers from being misused or distributed illegally in the first place, but it can also enable health professionals to identify patients who need help overcoming addiction.”
The report also found that rates of fatal overdoes grew more slowly in states that used state-issued prescription forms designed to curb fraud.
According to the U.S. Centers for Disease Control, over 15,000 Americans died from overdoses from prescription painkillers in 2009. Sales of the drugs to pharmacies and health care providers have increased by more than 300 percent since 1999.
Per capita consumption of painkillers such as hydrocodone, oxycodone and methadone is highest in the southeast (Florida, Alabama, Tennessee and Kentucky) and on the west coast (Washington, Oregon and Nevada).
“An epidemic of prescription drug abuse is devastating American families and draining state and federal time, money and manpower,” said Rep. Hal Rogers (R-Kentucky), chairman of the House Appropriations Committee. “Law enforcement and health officials are doing heroic work and, thankfully, this report provides a roadmap to help them further.”
PDMP’s may help prevent abuse, but they’ve had a negative impact on patients with legitimate prescriptions, according to one chronic pain sufferer.
“The PDMP Florida implemented is good in the sense that it does go after “doctor shoppers” by using a data base to find duplicate prescriptions, but it is bad in the sense that putting a limit on pharmacies indiscriminately punishes everyone from the disabled to the person who just had surgery to the terminally-ill,” Guy Abernathy wrote in an email to National Pain Report.
“There is very much an environment of intimidation that these doctors feel and patients feel like they are being treated like drug addicts. This is emotionally traumatizing and patients who suffer with chronic pain are already traumatized on a daily basis as pain leads to depression and generally a lower quality of life,” said Abernathy.
The Pew Health Group, a division of The Pew Charitable Trusts, provided funding for the Brandeis research.
“Prescription painkillers clearly play an important role in modern medicine, but their abuse is also responsible for mounting deaths, suffering and health care costs. These researchers’ work will advance the vital actions already being taken to attack this problem,” said Allan Coukell, director of medical programs for the Pew Health Group.