According to last month’s report from the CDC (Center for Disease Control and Prevention) the nation has experienced a sharp rise in the number of accidental drug overdoses and that rise is directly attributable to an increase in the usage of opioid medications.
In just the past eight years, the number of opioid-related overdoses has eclipsed those from cocaine and heroin combined. The situation is dire enough that the CDC is calling the misuse of prescription opioids an epidemic and is working hard to find ways to combat the problem.
Opioids are powerful analgesics, drugs intended to alleviate pain. According to CDC findings, those who are most likely to abuse these powerful medications are a) patients with medical reasons for taking the drugs in high dosages and b) those who intentionally seek out several doctors in order to obtain multiple high dose prescriptions – persons very likely to be involved in distribution of the drugs. New anti-abuse strategies under consideration by the CDC are aimed at these two high-risk groups.
Strategies for Reducing Prescription Drug Abuse
- Data-sharing programs and insurance-based restrictions
People who seek out several doctors in order to obtain multiple prescriptions are engaging in a practice known as doctor shopping. By promoting state prescription monitoring programs the CDC hopes to reduce a person’s ability to engage in doctor shopping. Prescription monitoring programs maintain a database of every doctor prescription a person is given enabling physicians to see a patient’s prescription history with a simple computer mouse click. The second arm of the strategy empowers insurance carriers to set limits on opioid prescription reimbursements. Insurance companies are also able to detect when there is not a proper correlation between the patient’s diagnosis and the opioid being prescribed.
This strategy focuses on better enforcement of already existing laws and the promotion of new legislation geared to cut down on fraudulent prescribing. Sadly, patients, doctors and even pharmacies have been part of the abuse problem. Laws against doctor shopping make doctors more responsible for their own prescribing practices and should be enforced. Some pharmacies, known as pill mills, dispense the medications with little or no demand for an actual doctor evaluation beforehand. Pill mill policies require that evidence of an actual physical exam by a physician be presented in order for pharmacies to fill prescriptions. In addition, persons wanting to have their prescriptions filled would need to present legitimate personal identification.
- Improved prescribing practices
The CDC will be pushing for doctors to follow evidence-based prescribing practices. To do this, efforts will be made to provide physicians with further education about the true risk/benefit of high dosage treatment with opioids. This strategy goes hand in glove with another strategy which promotes the establishment of state-set prescription guidelines.
- State prescribing guidelines
This strategy focuses on creating dosing guidelines set by the state for doctors to follow. Washington state is held up as an example of a state which offered physicians free continuing education credit for watching online information about random urine testing, best-practices for opioid treatments and developing a patient/prescriber form agreement. The guidelines established a set ‘yellow flag’ dosage and encouraged referrals to pain specialists. Further efforts are in the works to create training in pain-proficiency for those who are primary care providers.
State and federal agencies have a difficult task before them. The abuse of prescription drugs, particularly opioid analgesics is rampant, yet the quest to reduce prescription drug abuse must be balanced against the need to permit the appropriate use of these powerful medications. The strategies under consideration attempt to hold those two needs in proper tension.