Tag Archives: PDMPs

Opioid Addiction Epidemic Solutions

opioid

More than 72,000 people in the United States died from accidental drug overdoses last year, according to the Centers for Disease Control and Prevention (CDC). While it is difficult to quickly pinpoint the exact cause of a fatal drug overdose – prescription drugs, heroin, or synthetic opioids – opioid painkillers are one of the leading reasons. Drugs like oxycodone, hydromorphone, and hydrocodone are responsible for many deaths each year, despite efforts to rein in overprescribing and doctor shopping.

Even if a prescription opioid isn’t linked to an overdose death, there is a good chance that a victim was introduced to opiates by a physician. Deadly introductions to opioids are extremely common, the National Institute on Drug Abuse (NIDA) reports that 80 percent of heroin users first misused prescription painkillers. The reasons for changing from FDA-approved drugs to street-grade heroin vary; but, it often stems from a patient no longer being able to acquire their prescriptions easily.

Anyone living with opioid use disorder – whether they’re still active or in the first 5-years of recovery – knows that in most states it’s more difficult than before to meet the demands of their disease. Why is more challenging? Because practically every state in the country has some form of prescription drug monitoring program (PDMP); many doctors have a better understanding of the disease; and, most physicians are unable to write refill after refill for opioid narcotics. Patients are now receiving smaller, less potent drugs than before and more doctors are determined to taper patients off in a timely manner.

In many cases, not all, patients will turn to the black market to acquire the drugs they desire—narcotics that will prevent painful withdrawal symptoms. However, many Americans still find ways to obtain their prescription meds and use them in dangerous ways.

Prescription Drug Monitoring Program Mandate

PDMPs exist, but few doctors rely on the life-saving tools! Each doctor gives their reasons for resistance, and such reasons vary from state-to-state. Here in California, and despite being the first state to implement a PDMP, the track record of use is nothing short of dismal.

The Controlled Substance Utilization Review and Evaluation System, or CURES, debuted in 1997; but, by 2012 less than 10 percent of providers and pharmacists had signed up for access to the database, according to a Los Angeles Times investigation. In 2012, the opioid addiction epidemic was well underway, and Californians were succumbing to overdoses at a staggering rate. Moreover, few doctors were turning to CURES to learn about their patient’s prescriptions, who prescribed the drugs, and which pharmacies filled them.

Given that doctors are in a wholly unique position to identify patients at risk of abuse, or those already showing signs of addiction, utilizing CURES is no longer up for debate. Whether a physician likes the database or not (some have complained that it is hard to use), starting next month use is mandatory, The Los Angeles Times reports. State Sen. Ricardo Lara’s SB 482 goes into effect requiring, among other things, that:

A health care practitioner authorized to prescribe, order, administer, or furnish a controlled substance to consult the CURES database to review a patient’s controlled substance history no earlier than 24 hours, or the previous business day, before prescribing a Schedule II, Schedule III, or Schedule IV controlled substance to the patient for the first time and at least once every 4 months thereafter if the substance remains part of the treatment of the patient.

Stemming the Tide of Addiction With Due Diligence

Despite being around for more than 20 years, the program has had a number of problems that have been addressed over the years. Originally described as “clunky and far from user-friendly,” the system was revamped in 2009 and CURES 2.0 was released in 2016 with a better interface, according to the article. The newer database is far from perfect and can use some improvements; even still, compulsory use of CURES will undoubtedly save lives.

California joins New York, Kentucky, and Tennessee in requiring doctors to consult a prescription drug database before prescribing. According to the article, a 2017 study showed that mandatory use of New York’s I-STOP database in 2013 led to a leveling off of prescription opioid deaths in the state.

California created the first system to track prescriptions of the strongest painkillers, but our state fell behind as the opioid crisis grew,” said state Sen. Ricardo Lara (D-Bell Gardens), who drafted the legislation in 2015. “I wrote SB 482 to require that doctors and others consult the CURES system before prescribing these powerful and addictive drugs. This tool will help limit doctor shopping, break the cycle of addiction and prevent prescriptions from ever again fueling an epidemic that claims thousands of lives.”

Opioid Use Disorder Treatment for Men

Please reach out to PACE Recovery Center if you are struggling with prescription opioids or heroin, or your loved one is about to complete inpatient treatment and can benefit from extended care. Relying on a combination of traditional and alternative therapeutic methods, we can help you or a family member enter into a life of recovery from opiate addiction.

If you are in crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or contact the Crisis Text Line by texting TALK to 741741.

Prescription Drug Monitoring Programs (PDMPs)

PDMPsRecently, CNN’s Chief Medical Correspondent Dr. Sanjay Gupta wrote and published an op-ed to coincide with a special report about prescription opioids. Dr. Gupta covered a number of different aspects about the state of the American opioid epidemic and expounded on how the situation became so dire. Perhaps the most interesting aspect about the article was Gupta essentially holding doctors responsible for the market share of the crisis and calling on physicians to do their part to reverse the damage. It is important to keep in mind that there are several different factors that led to the emergence of an epidemic, and while doctors did and continue to overprescribe opioid narcotics, a multifaceted approach from lawmakers, addiction experts and doctors is essential for ending the scourge that claims over 70 lives in this country every day. It is widely accepted that Americans, enabled by doctors, have become far too reliant on prescription opioids—even for pain that could be treated by opioid alternatives. What’s more, while the the vast majority of prescription opioids are written by primary care physicians, few doctors have any opioid prescribing practices training or knowledge about addiction. On top of that, there has not been a huge push from medical organizations urging doctors to acquire the requisite training. Even the American Medical Association (AMA) is resistant to having doctors trained to prescribe responsibly. Hopefully, in the near future doctors will heed the call from Gupta to be a part of the solution, rather than part of the problem. When discussing the American opioid epidemic, the conversation typically is about how bad it is; however, it is important that we take a moment to recognize the strides that have been made in the right direction.

PDMPs

Several years ago, amidst widespread overprescribing by pain management clinics—otherwise known as “pill mills”—and rampant “doctor shopping,” the act of going to multiple doctors in a month to double and triple up on one’s prescription opioids, states began to implement what are known as prescription drug monitoring programs (PDMPs). The programs were designed to give doctors a resource for identifying doctor shoppers and to give authorities a window into which doctors are prescribing suspiciously. PDMPs were met with resistance by some doctors, and to this day there is a significant number of them who do not utilize the resource; but, drug monitoring programs have proved to be an invaluable resource. Today, 49 states have adopted a PDMP of some kind, and there is now evidence that suggests the programs are having the desired effect. In fact, new research from Weill Cornell Medical College has found that, in the states that have implemented a PDMP, a 30 percent decrease in prescriptions for opioids and other narcotics could be seen, NBC News reports. The findings were published in the journal Health Affairs.
This reduction was seen immediately following the launch of the program and was maintained in the second and third years afterward,” writes researcher Yuhua Bao and colleagues. "Our analysis indicated that the implementation of a prescription drug monitoring program was associated with a reduction in the prescribing of Schedule II opioids, opioids of any kind, and pain medication overall.”

Uncertain Conclusions

The news is without a doubt a breath of fresh air, yet in the wake of the death of pop superstar Prince—clearly we as a nation have a long way to go. The research team believes that there could be a number of reasons for the PDMP success. The 30 percent drop in written prescriptions, according to researchers could be that PDMPs:
  • Raised awareness about opioid abuse with doctors.
  • Made doctors more cautious about writing prescriptions that can lead to dependence and addiction.
  • Caused doctors to cut back on prescriptions knowing that they were being watched.
Regardless of the reason for PDMPs causing a reduction, they have had a notable impact which indicates that efforts to curb the problem have had some success. Before PDMPs 5.5 percent of doctor’s visits involving pain management resulted in a prescription for an opioid being written, after drug monitoring programs that number fell to 3.7 percent.

Addiction Treatment

Cutting back on the number of prescriptions written is paramount, unfortunately opioid addicts who struggle to get their pills will more times than not turn to heroin as an alternative. Simply making it harder to get drugs doesn't mean that people will be free of addiction. It cannot be stressed enough just how vital addiction treatment services are to ending the epidemic in the U.S. At PACE Recovery Center, our qualified staff can assist you or a loved one in ending the cycle of addiction. We can show you how it is possible to live a healthy, productive life free from drugs and alcohol. Please contact PACE to begin the life changing journey of addiction recovery.

House Unanimously Passed Bills Aimed at Opioid Abuse

opioidsLawmakers in Massachusetts continue to spearhead an operation against the opioid epidemic devastating major cities and small towns across the nation. Massachusetts is a state that has felt the overwhelming effects of this crisis, a scourge unprecedented in our times. Lead by U.S. Rep. Joseph P. Kennedy III and U.S. Rep. Katherine Clark, the U.S. House of Representatives unanimously passed two bills devised to combat the insidious effects of opioid abuse, the Boston Herald reports. Kennedy said the unanimous support “speaks to the breadth and depth of the opiate abuse epidemic.” The bill that Kennedy co-sponsored reinstates federal funding to states prescription drug monitoring programs (PDMPs). Monitoring programs deter “doctor shoppers,” people who go to multiple doctors every month for the same types of prescriptions. While PDMPs exist in 49 states, the need for a nationwide system is necessary. The funding will also be used for drug screening and substance use disorder treatment, according to the article.
There are few people in this country who have been spared the heartbreak of watching a loved one, neighbor or friend fall victim to opiate addiction,” said Kennedy. “It’s an epidemic striking red states and blue states, small towns and big cities, neighborhoods rich and poor.”
Clark’s bill, if passed by the Senate, creates uniform standards for diagnosing and treating neonatal abstinence syndrome (NAS). The syndrome occurs when fetuses are exposed to opioids, after birth they experience withdrawal symptoms which require extra medical care. The bill would become the first law to address newborns exposed to opioid use, the article reports.
Right now there is no standard for treatment with NAS,” Clark told the Herald. “This problem leads to long stays in the NICU and hundreds of millions in Medicaid dollars.”
___________________________________________________________________________ If you or a loved one suffers from opioid addiction, please contact Pace Recovery Center.

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