Drug testing, which allows clinicians to ensure that patients are taking their prescription medications, can help healthcare providers to design and safely manage a treatment
program as well as discourage misuse.
dangers of inappropriate use of all types of drugs is more likely to be effective. In fact, there are signs that suggest that
current efforts may be working. Although our 2014 report showed that medication misuse remains very high, we also found that the rate of misuse, as determined by drug test results, declined by 8 percent from 2011 to 2013, sug- gesting that physicians may be doing a beter job communicating about the importance of adherence to a prescription drug regimen and/or that patients are exercising beter pre- scription drug compliance. Tis data also sup- ports NSDUH research which shows that in 2011, illicit use of prescription drugs declined for the first time in more than two decades. Past month nonmedical use of psycho- therapeutic drugs (pain relievers, stimulants, tranquilizers and sedatives) by those 12 and
68 datia focus
older dropped by 14 percent from 7 million in 2010 to 6.1 million in 2011. Additionally, our data showed that
adolescents experienced the greatest gains in appropriate drug use. Inconsistency rates for patients ages 10–17 decreased from 70 percent in 2011 to 57 percent in 2013, an improvement of 13 percentage points in two years. Patients ages 64 years and older had the lowest rate of inappropriate drug use, at 44 percent, according to test results. Our analysis also provided directional
guidance on the types of clinical, techno- logical and policy strategies that can help curtail the prescription drug epidemic:
Invest in comprehensive, state-run prescription medication abuse prevention approaches. Research found that the five states that have implemented multi-faceted prescription drug abuse prevention programs in recent years showed the greatest rate of decline in prescription drug misuse rates nationwide. In Florida, Georgia, Kentucky, New York and Tennessee, the average decline in misuse rates over the last three years; the average de- cline for these states was 10.7 percent, nearly
2.5 times higher than the average decline of 4.4 percent among other states combined.18
Promote data sharing via state Prescription Drug Monitoring Programs (PDMPs). In 2006, only 20 states had PDMPs. Today, 49 states have laws authorizing PDMPs, and 48 states have operational programs.19 Efforts are underway to increase data shar- ing with other states’ systems, and many PDMP administrators are working to beter integrate these systems into other health IT programs. Tese efforts will help all those who play a role in reducing drug abuse, from law enforcement to physicians.
Enhance clinical
assessment of risk with objective drug tests. Too often, physicians say they can always spot a patient who is at risk of abusing drugs. This is unlikely, given research that finds all patients are at risk, regard- less of socioeconomic level, gender or age.20
And patient questionnaires and re-
liance on self-reporting about drug abuse are unreliable predictors of prescrip-
spring 2015
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