New findings stress need for prescription registries
A Stanford University study published Monday provides new revelations on our country’s addiction to prescription painkillers.
The news is not good.
The study, published in the Journal of American Medical Association, looked at Medicare prescription drug claims for 2013 and found that we were wrong about how the powerful, addictive drugs were flooding the market.
The study found that prescriptions per provider were concentrated among some specialty services. But by sheer volume general practitioners, which collectively handed out 35.3 million prescriptions for Schedule II opioids in 2013, dominated the total quantity of prescriptions.
In other words, the flood of opiate painkillers gripping our country isn’t the product of corrupt doctors or so-called “pill mill” operations. Most scripts come from legitimate, upstanding practitioners.
Dr. Jonathan Chen, the lead author of the Stanford study, called for a sea-change in how we try to curb over-prescription of the drugs.
“Efforts to curtail national opioid overprescribing must address a broad swath of prescribers to be effective,” Chen wrote.
One such effort here, Pennsylvania’s creation of a prescription drug database, is an important tool in that fight.
The scope of our dependence upon opioid painkillers is mind-boggling. In 2014 the U.S. accounted for five percent of the world’s population and consumed at least 75 percent of all opioid prescription drugs, according to the National Institute on Drug Abuse.
On average, 46 people in the U.S. die each day from painkiller overdoses, according to the Centers for Disease Control.
In 2011 there were 1,909 accidental prescription drug overdoses in Pennsylvania, according to the state Department of Health — an increase of nearly 150 percent since 2001.
Despite those facts, oversight of prescription opioid users remains lax according to a 2014 study by Express Scripts, a mail-order pharmaceutical company that fills billions of prescriptions each year.
In 2013 nearly 60 percent of users were combining the drugs with other medications, like anti-anxiety or muscle relaxant pills, in potentially hazardous or deadly ways, according to the study.
Nearly 28 percent were combining longer-term opiates with short-acting opiates, significantly increasing their risk of addiction.
Most states — 49 in fact — already run prescription drug registries like the one Pennsylvania enacted last fall. But the databases can’t be effective if doctors don’t or won’t use them.
Pennsylvania’s database isn’t operational yet. The state Department of Health, which will oversee the database, needs to get it up and running as soon as possible.
Doctors, some of whom believe the system needs to do more to protect access to patients’ data, need to fully buy in to make the database an effective tool against doctor shopping and opioid abuse and misuse.
