Painkiller overdoses often involve 'pharmacy shopping'

(HealthDay)—Nearly half of all deaths resulting from an overdose of narcotic painkillers involved Medicaid recipients who used multiple pharmacies to fill their prescriptions, a new study finds.

"Pharmacy shopping," or the use of multiple pharmacies at the same time, is a way some patients obtain more medication than they need. Medicaid programs in many states track the number of pharmacies patients visit to prevent such abuse of painkillers, the study authors said.

It's unclear, however, how many pharmacies must be visited or how much time should lapse between prescriptions to identify patients engaging in pharmacy shopping with the intent to misuse their medication. Some patients, the study authors pointed out, may legitimately use more than one pharmacy if they move, travel or make a change in their insurance coverage.

To investigate this issue, researchers examined the records of more than 90,000 Medicaid recipients aged 18 to 64, who were long-term users of narcotic painkillers, such as Oxycontin (oxycodone) or Vicodin (hydrocodone). These patients had used three or more narcotic prescriptions for 90 days from 2008 to 2010.

Patients using overlapping painkiller prescriptions had a higher rate of overdoses, the study published recently in The Journal of Pain revealed. Patients who used four pharmacies within 90 days, which the study said could be considered an indication of pharmacy shopping, had the highest odds of overdosing.

Study author Zhuo Yang, of the U.S. Centers for Disease Control and Prevention, and colleagues concluded that the use of overlapping prescriptions and multiple pharmacies isn't medically reasonable or necessary. Programs to restrict reimbursement for controlled prescriptions, such as narcotic painkillers, could designate one pharmacy and one doctor for patients on these medications, they suggested.

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