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    Prescription Monitoring System Reduces Abuse, Improves Compliance

    By Jennifer Huddleston, staff writer     

    A recent study suggests that electronic prescription monitoring programs may decrease opioid abuse, addiction and diversion, which is good news for a nation where in 2006, the last year for which data is available, drug-induced deaths exceeded gun-related deaths and were the second-ranking cause of accidental death, preceded only by motor vehicle accidents. [1]

    Prescription painkiller abuse is a growing problem for the U.S., as evidenced by many national surveys. According to the 2009 National Prescription Drug Threat Assessment (NPDTA), a product of the National Drug Intelligence Center (NDIC) and the Drug Enforcement Agency (DEA), accidental deaths involving prescription painkillers increased 114 percent between 2001 and 2005.

    A recent article in Anesthesiology News reported on a study of Indiana’s INSPECT program, which was launched in January 2008. The INSPECT program requires all licensed distributors in Indiana to submit data, consisting of 10 questions, every seven days for all Schedule II-V controlled substance prescriptions.

    In an attempt to assess the efficacy of the program as it relates to prescription opioids, David Miller, M.D., an anesthesiologist and medical director of Woodland Pain Center in Michigan City, Indiana, studied 125 patients from his interventional chronic pain practice.

    Miller used urine drug screens to determine whether the patients were abusing opioids. The patients were divided into two groups. Group 1 was tested prior to the launch of the INSPECT program while Group 2 was tested after the program had taken effect. Both groups consisted of patients with a similar median age, gender ratio and distribution of primary insurance coverage.

    Results of the urine drug screens were considered abnormal if they showed the presence of opioids or benzodiazepines in the urine of patients who did not report having active prescriptions for such drugs. Results were also considered abnormal if the urine screens found the presence of illegal drugs or if a patient’s prescribed opioids were not found in their urine.

    Miller’s study found that 11 percent of patients in the monitored group had abnormal drug screen results, compared with 33 percent of patients in the group that was not monitored.

    With obvious evidence that people are less likely to abuse prescription drugs when they are being monitored, it seems logical that the next step would be to implement a nationwide electronic prescription monitoring system that could possibly reduce controlled substance abuse and diversion, which cost health insurance companies approximately $72.5 billion each year.
    [3] The NPDTA report showed that between 2003 and 2007, 7 million Americans age 12 and older reported using prescription drugs for non-medical purposes in the past month.

    Unfortunately it seems that such a nationwide system is not that easy to create or put into action.

    “It’s an expensive proposition which is made even more difficult by individual state privacy regulations,” said Bill Lockwood, executive director of the American Society for Automation in Pharmacy, which supports pharmacies’ use of technology. According to Lockwood, many Americans are afraid that their personal information or patient records will not be secure.

    According to the DEA, 38 states had passed legislation requiring prescription drug monitoring programs as of November 2008. At the time, six were in the works and 32 were in effect.

    The National All Schedules Prescription Electronic Reporting Act (NASPER), designed to provide some $60 billion to coordinate prescription monitoring systems in each state in the U.S., was signed into law by then-President George W. Bush in 2005 but has since lost momentum in Congress and has not received the funding it requires.

    [1] “Prescription Opioid-related Deaths Increased 114 Percent from 2001 to 2005, Treatment Admissions Up 74 Percent in Similar Period; Young Adults Hardest Hit.” Office of National Drug Control Policy Press Release. May 20, 2009.
    [2]  Ibid.
    [3]  Ibid.
    [4] Campion, Michelle Grey. “State Monitoring Program Lowers Opioid Noncompliance, Abuse.” Anesthesiology News. Volume 35:4. April 2009.

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