As painkiller overdoses mount, researchers outline effective approaches to curb epidemic

September 20, 2012

Prescription painkillers are responsible for more fatal overdoses in the United States than heroin and cocaine combined. And while most states have programs to curb abuse and addiction, a new report from Brandeis University shows that many states do not fully analyze the data they collect.

Experts from the Prescription Program Center of Excellence at Brandeis University's Heller School for Social Policy and Management systematically assessed prescription drug monitoring programs and found a patchwork of strategies and standards. Their report also outlines best practices that all U.S. states and territories can use to improve their effectiveness.

"An epidemic of prescription drug abuse is devastating American families and draining state and federal time, money and manpower," said Rep. Hal Rogers (R-Ky.), chairman of the House Appropriations Committee. "Law enforcement and are doing heroic work and, thankfully, this report provides a roadmap to help them further."

Among the study's primary conclusions: prescription drug monitoring programs should shift from a reactive to a proactive approach.

"Being proactive is the key to success in the fight against prescription painkiller abuse," said John L. Eadie, Director, PDMP Center of Excellence at the Heller School for Social Policy and Management, Brandeis University. "While doctors may routinely collect and report data to a state program that signals where and when are likely being misused, the program might not share that information with others who can best use it."

"State programs should analyze the data they collect," Peter Kreiner, Principal Investigator of Brandeis' , continued, "and reach out to prescribers, pharmacists, insurers, law enforcement agents and others who can prevent powerful narcotics from falling into the wrong hands. Where this is already taking place, it has proven to be very effective."

"Good things happen when state prescription drug monitoring programs shift to a proactive strategy," said Dr. Nathaniel Katz, assistant professor of anesthesia at Tufts University School of Medicine. "Not only can it prevent painkillers from being misused or distributed illegally in the first place, but it can also enable health professionals to identify patients who need help overcoming addiction."

By the end of 2001, the report found that 16 states had authorized the creation of prescription drug monitoring programs; within 11 years that number had grown to 49. Today, 41 states have programs in operation.

The paper identified several practices with demonstrated effectiveness. For example:

  • States that collected prescribing data for all controlled substances (e.g., anti-anxiety medication as well as painkillers) reported lower rates of doctor-shopping (visiting multiple doctors to obtain prescriptions) than other states.
  • The rates of fatal painkiller overdoses grew more slowly in three states using state-issued prescription forms with uniquely configured page numbers, a practice designed to curb fraud.
  • Proactively sending alerts about possible abuse to physicians and pharmacists was associated with decreased prescription sales and lower rates of doctor-shopping.
  • Analyzing trend data helped law enforcement agencies identify "pill mills" that were illicitly distributing prescription painkillers.
  • Boosting doctors' participation in and utilization of prescription drug monitoring programs was associated with reduced fatal prescription painkiller .
"BJA has historically provided strong support for the promulgation and dissemination of best practices," said Denise O'Donnell, Director of the Bureau of Justice Assistance, U.S. Department of Justice, "and we are gratified by the publication of this paper, which provides much needed guidance and support for how states can most effectively utilize their prescription drug monitoring programs."

The Pew Health Group, a division of The Pew Charitable Trusts, provided funding for the research.

"Protecting patients from medical risks and ensuring their access to safe and effective therapies are significant goals for Pew," said Allan Coukell, director of medical programs for the Pew Health Group. "Prescription painkillers clearly play an important role in modern medicine, but their abuse is also responsible for mounting deaths, suffering and health care costs. These researchers' work will advance the vital actions already being taken to attack this problem."

Explore further: Deaths from painkiller overdose triple in decade

Related Stories

Deaths from painkiller overdose triple in decade

November 1, 2011
The number of overdose deaths from powerful painkillers more than tripled over a decade, the government reported Tuesday - a trend that a U.S. health official called an epidemic, but one that can be stopped.

Drug-monitoring programs needed to cut dangers linked to 'pharmaceuticalization' of 21st century

May 30, 2012
Individual use of prescription opioids has increased four-fold since the mid-1990s, in part due to increased awareness of pain control for chronic conditions such as low back pain and fibromyalgia and a Joint Commission mandate ...

Suboxone is most effective in treating painkiller addiction

November 7, 2011
Individuals addicted to prescription painkillers are more likely to succeed in treatment with the aid of the medication buprenorphine-naloxone (Suboxone), report McLean Hospital and Harvard Medical School researchers in today's ...

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

August 16, 2012
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 ...

Increase in Internet access parallels growth in prescription drug abuse

May 12, 2011
Increasing access to rogue online pharmacies – those which dispense medications without a doctor's prescription – may be an important factor behind the rapid increase in the abuse of prescription drugs. In a report ...

Recommended for you

Sensor-equipped pill raises technological, ethical questions

November 17, 2017
The first drug with a sensor embedded in a pill that alerts doctors when patients have taken their medications was approved by the Food and Drug Administration, raiding issues involving privacy, cost, and whether patients ...

New painkillers reduce overdose risk

November 16, 2017
Scientists on the Florida campus of The Scripps Research Institute (TSRI) have developed new opioid pain relievers that reduce pain on par with morphine but do not slow or stop breathing—the cause of opiate overdose.

Separating side effects could hold key for safer opioids

November 16, 2017
Opioid pain relievers can be extremely effective in relieving pain, but can carry a high risk of addiction and ultimately overdose when breathing is suppressed and stops. Scientists have discovered a way to separate these ...

US regulators approve first digital pill to track patients

November 14, 2017
U.S. regulators have approved the first drug with a sensor that alerts doctors when the medication has been taken, offering a new way of monitoring patients but also raising privacy concerns.

Introduction is different, but top medications for opioid addiction equally effective

November 14, 2017
With opioid addiction officially declared a public health emergency in the U.S., medical intervention to treat the illness is increasingly important in responding to the epidemic. Now, a new study concludes that two of the ...

Drugstore pain pills as effective as opioids in ER patients

November 7, 2017
Emergency rooms are where many patients are first introduced to powerful opioid painkillers, but what if doctors offered over-the-counter pills instead? A new study tested that approach on patients with broken bones and sprains ...

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.