Use of PMP may increase demand for drug treatment, reduce painkiller abuse

August 16, 2012, Lifespan

A Rhode Island Hospital researcher has found that the use of electronic prescription drug monitoring programs (PMPs) may have a significant impact on the demand for drug treatment programs and how prescribers detect and respond to abuse of painkillers. The study by Traci C. Green, Ph.D., MSc, research scientist in Rhode Island Hospital's department of general internal medicine, is published online in advance of print in the journal Pain Medicine.

The study surveyed 1,385 providers in Rhode Island and Connecticut on their use of state PMPs, and found that PMP use was greater in Connecticut where an electronic PMP is available. PMPs are used to gather information about a patient's prescription history, and have the ability to verify patients' self-reported prescription history of abusable medications, aid in the determination of filling multiple prescriptions of the same drug from multiple providers, and assist in the cataloging of medications that may suggest contra-indications or increased risk of , like overdose.

Both states have reported significant increases in opioid-related death; in fact, overdose has surpassed as the leading cause of unintentional injury death. A indicates that Rhode Island has the highest per capita and ranks third, behind Oklahoma and Oregon, for non-medical use of prescription opioids among persons age 12 or older.

"Prescription programs have historically been oriented to criminal and judicial end users," Green said. "Use of PMPs by prescribers is growing, but how clinicians in actual practice use the data that these systems contain is not well understood."

The researchers surveyed providers in both states who are licensed to prescribe Schedule II medications. These medications have a high potential for abuse, which may lead to severe psychological or physical dependence. Schedule II medications include , Dilaudid, Demerol, , fentanyl, and methamphetamine, among others.

The study found that prescribers' use of an electronic PMPs may influence medical care and decisions, especially with opioid abuse detection, and is associated with clinical responses to suspected doctor shopping or diversion. Doctor shopping refers to patients who seek to obtain multiple prescriptions for abusable medications from multiple doctors.

When prescribers suspected a patient of doctor shopping or diverting medications, PMP users were more likely to ramp up clinical monitoring with urine drug screens or refer the patient to drug treatment. PMP users were also less likely to ignore the warning signs or to call law enforcement.

"One thing is clear," Green said, "Clinicians, not law enforcement, have the medical and behavioral health care expertise to guide patients struggling with addiction to get the help they need, when they are ready for it. PMPs can be an important clinical tool to address possible addiction issues and start that conversation."

Green added, "Our study suggests that if states want wider use of PMPs by their prescribers, we need to increase access to drug treatment, especially opioid-dependence treatment options, if we are going to make headway on the epidemic of painkiller abuse and overdose death in our communities."

Since the mid 1990s, there has been a significant nationwide increase in fatal overdose and opioid-related emergency department visits and hospitalizations, driven by a substantial growth in opioid analgesic prescriptions and non-medical use of prescription . Most states report that just 25 percent of their prescribers are using PMPs, and few states require prescribers to check PMPs before dispensing medication.

"PMPs raise the red flags we could be missing on our own," Green said. "They call attention to multiple prescriptions by different doctors, and note contra-indications that put the patient at risk for injury or death. But not enough prescribers are using them. We need to further educate clinicians about these programs, improve options and access, and make electronic PMPs more readily available so that this tool can be used most effectively to prevent unnecessary medication-related injury and death."

Explore further: Teach prescribers about dangers of long-acting pain meds: FDA

Related Stories

Teach prescribers about dangers of long-acting pain meds: FDA

July 9, 2012
(HealthDay) -- As part of its efforts to curb the abuse of narcotic painkillers, the U.S. Food and Drug Administration is requiring drug makers to educate doctors about the risks of long-acting and extended-release forms ...

Study analyzes link between HIV infection and overdose risk

December 12, 2011
A study from Rhode Island Hospital is the first to systematically review and analyze the literature on the association between HIV infection and overdose risk. The findings show a 74 percent greater risk of overdose among ...

New FDA program adds to tools to curb opiod abuse in United States

August 1, 2012
A new risk management plan from the U.S. Food and Drug Administration to help clinicians properly prescribe drugs with addiction potential aims to help reduce the growing epidemic of opioid abuse in the United States. With ...

Methadone linked to 30 percent of painkiller overdoses

July 4, 2012
The prescription drug methadone is linked to over 30 percent of painkiller overdose deaths, according to a report released by the Centers for Disease Control (CDC) and Prevention Tuesday.

Recommended for you

In most surgery patients, length of opioid prescription, number of refills spell highest risk for misuse

January 17, 2018
The possible link between physicians' opioid prescription patterns and subsequent abuse has occupied the attention of a nation in the throes of an opioid crisis looking for ways to stem what experts have dubbed an epidemic. ...

Patients receive most opioids at the doctor's office, not the ER

January 16, 2018
Around the country, state legislatures and hospitals have tightened emergency room prescribing guidelines for opioids to curb the addiction epidemic, but a new USC study shows that approach diverts attention from the main ...

FDA bans use of opioid-containing cough meds by kids

January 12, 2018
(HealthDay)—Trying to put a dent in the ongoing opioid addiction crisis, the U.S. Food and Drug Administration on Thursday slapped strict new restrictions on the use of opioid-containing cold and cough products by kids.

Taking ibuprofen for long periods found to alter human testicular physiology

January 9, 2018
A team of researchers from Denmark and France has found that taking regular doses of the pain reliever ibuprofen over a long period of time can lead to a disorder in men called compensated hypogonadism. In their paper published ...

Nearly one-third of Canadians have used opioids: study

January 9, 2018
Nearly one in three Canadians (29 percent) have used "some form of opioids" in the past five years, according to data released Tuesday as widespread fentanyl overdoses continue to kill.

Growing opioid epidemic forcing more children into foster care

January 8, 2018
The opioid epidemic has become so severe it's considered a national public health emergency. Addiction to prescription painkillers, such as oxycodone and morphine, has contributed to a dramatic rise in overdose deaths and ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.