Archive for August, 2016
There is an ongoing and growing problem on opioid use and abuse, becoming a pandemic on its own. Many people have fallen victim to opioid use because the drug is readily available and accessible.
The U.S. Department of Justice decided to take matters into action and enacted a program that can effectively monitor and lessen the opioid abuse. Prescription Drug Monitoring Program (PDMP) is a state-run electronic database to track the prescribing and dispensing of controlled substances. This program is designed to monitor drugs that are suspected to be addicting. Also, it also provides critical information regarding a patient’s controlled substances prescription history.
Opioid Abuse and Addiction
A brewing problem against drug addiction has been increasing with the use of over-the-counter medicine as a means for opioid abuse. Opioid analgesics intended to relieve pain are often used improperly, resulting to abuse and addiction. It has becoming a wide-scale problem that has resulted to opioid overdose.
From 2003 to 2009, the numbers of death caused by drug overdose has increased to 61 percent in Florida alone. Most of the fatalities are caused by the infamous opioid pain relievers oxycodone and benzodiazepine alprazolam.
Addiction to opioids such as prescription pain relievers, heroin and morphine affects the health and social welfare of most societies. There are roughly 26.4 million people who abuse opioid while there are approximately 2.1 million users in United States, 470,000 of which are already addicted and are suffering health issues because of their addiction.
Opioid is a respiratory depressant that can cause death when abused and used regularly. The reason why it has become the popular choice for addicts is because it is easily available and accessible. Prescription pain relievers can be easily bought in drug stores and is readily available in black markets.
Opioids are substances that acts like opioid receptors for a morphine-like effect. The drug is highly addictive and can illicit physical dependence when used and abused. These receptors can mediate the psychoactive and somatic effects, which produce the tendency for the user to have an altered state of mind.
Abuse of opioids can lead to side effects like itchiness, nausea, euphoria and respiratory depression.
What is Prescription Drug Monitoring Program?
The National Alliance for Model State Drug Laws (NAMSL) defined Prescription Drug Monitoring Program as the statewide electronic database that collects the data on a particular drug dispensed in the state. It is housed under specified regulations by administrative and law enforcement agencies.
NAMSL distributes the data from the individuals who are authorized to receive the information for the purpose of their profession. Since PDMP is used as a tool by states to address prescription drug abuse and addiction, it is served with several purposes such as to provide support access to effectively and properly use controlled substances as medication. This is to educate individuals about the use of PDMP and potential abuse and addiction to other prescription drugs that will help to identify, determine and prevent the drug abuse and diversion.
PDMP also serves the purpose of information dissemination in outlining use and abuse trends as a form of public health initiative. This is an important part of the program to facilitate and encourage the intervention and treatment of persons addicted to prescription drugs.
As of October 16, 2011 there are 37 states running operational PDMPs that have the capacity to receive and distribute controlled substances. Some of the states with fully operational PDMP include Ohio, Wyoming, New York, North Carolina and South Carolina. There are also eleven states that have enacted the use of PDMP to alleviate drug abuse even though it’s still not fully operational, and these include Alaska, Washington, New Jersey, Wisconsin, Arkansas and Maryland. Each of these states has a designated agency as to which will oversee the Prescription Drug Monitoring Programs, and these comprises of health departments, state law enforcement or pharmacy boards.
The Alliance of States with Prescription Monitoring Programs maintains a list of the state contacts to ensure that each state agency will be given attention. The group helps state agencies monitor how the program is going, guarantee that each state control will have the access to PDMP information, and also receive short descriptions as to the purpose of the programs in alleviating drug abuse in the society.
It is also important to note that The National Alliance State Drug Laws are provided links as to each state’s statute, regulations and law pertaining to prescription drug monitoring. In order to effectively run the prescription drug monitoring program, federal funding should be readily available in implementing the grant needed to proceed with the program.
The U.S. Department of Justice and the Bureau of Justice Assistance together with the Office of Justice organized and administered the Harold Rogers Prescription Drug Monitoring Program (HRPDMP) to provide three types of grants for planning, implementation and enhancement. Since inception, 47 states and 1 U.S. state territory have been funded under the grant program.
In an effort to administer the grant program effectively, the National All Schedules Prescription Electronic Reporting Act (NASPER) was enacted last 2005 to implement and enhance different programs for prescription drug monitoring. Since it has been created by the U.S. Department of Health and Human Services, NASPER has received $2 million in 2009 and 2010 to support grants in 13 states.
Although NASPER and HRPDMP are part of a working force duo in terms of prescription drug monitoring, they still have different purposes. HRPDMP’s responsibility is to enhance the capacity and scope of regulatory law enforcements and agencies to collect data from controlled substance and should be maintained through a centralized database administered by an authorized agency. On the other hand, NASPER aids in managing the grant program under the authority of HHS.
Prescription Drug Monitoring Program to Mitigate Opioid Use and Abuse
Since there is a steady growth and increase on the opioid use and abuse leading to addiction, some government agencies and health organizations are looking for a way to resolve this issue. The specific issue of opioid abuse and addiction can be solved by an effective information campaign. Letting the patients know the harmful benefits of the drug can be a useful way to lessen the abuse of opioids.
Prescription drug monitoring programs should have basic patient information and must also have the following data:
- Prescription number
- Date the prescription was issued
- Date that the prescription was last filled
- Number of refills ordered
It is important to know how many times the patient has used the drug and how often they have their prescription filled. The database of PDMP is updated by a pharmacist, who enters prescription data into the database within three days after dispensing. This is to ensure that a person or a patient is taking the controlled substance or medication properly, thereby reducing the risk of opioid abuse.
Prescription drug monitoring programs are highly effective tools that run in each state for the government to utilize in order to lessen the abuse of prescription drugs.
The programs collect and analyze electronically transmitted data, which are administered and submitted by pharmacists and practitioners. The data collected are used to manage and support the state’s efforts in research, enforcement and abuse prevention.
Prescription drug monitoring program is an operative tool and method to mitigate the abuse of opioids. However, there are also underlying disadvantages and inconsistencies when utilizing the program. Some of these hindrances that pose problems on the effectiveness and success of prescription drug monitoring data systems include the following;
- Inconsistency of the prescribers of the program
- Inconsistency in sharing the information across states
- Access to data separate to the one being used to access the records
- No mandatory requirement for the prescriber to consult with the database before prescribing and distributing the controlled substances
Proposed Actions to Address the Opioid Epidemic
Opioid abuse is imminent and is quickly becoming a wide-scale problem due to easy access and availability of these drugs. One effort that has been taken into action is implementing programs like the PDMP to aid in monitoring and collecting data that can mitigate the use of opioids. However, the current programs being executed and applied today still contain loopholes that make them limited in terms of their success in combatting drug abuse and addiction.
An ideal prescribed drug monitoring program should be able to alert the administrators of signs that pertain to illegal and aberrant drug procurement behavior. Furthermore, it should also be able to monitor controlled substances that fall within Schedule III, Schedule IV and Schedule V. These types of drugs and substances are prone to addiction and can be highly addictive, and that is why it is important to take these drugs only when necessary.
Actions to address the opioid endemic and take action in combatting the addiction problem is improve on prescribed drug monitoring programs and also enhance information dissemination as to what the state and health providers need to know to make the program effective. To improve the use of the program, it is important that PDMP should have easy access and real-time updates to the database.
Interstate accessibility is also integral to make sure that the centralized database is always up to date, and it must be synced together as well. There should be mandatory reporting on the update with controlled substances.
To make the PDMP a useful tool to mitigate the diversion of opioids, research should be done to optimize the use of the program. Also, the goal of a research study should be able to differentiate users and non-users, and the schedule by which clinicians and pharmacists should respond to the data.
Another effort and action to be considered is to expand access to treatment. When treating opioid overdose, it is better that physicians are well-prepared in treating opioid use disorder. Also, increasing the availability of community treatment programs should also be prioritized.
Lastly, an inter-agency task force should be created and grouped for the advancement on the access to mental health and abuse use treatment. The goal of this group is to promote best practices and develop additional agency guideline.
These plans in improving the programs are to expand public health partnerships to invest more in community policies that will help in combatting the opioid abuse epidemic.