“We have the moral resources to do the job…but time is critical. Every day we lose compounds the tragedy which drugs inflict on individual Americans.”
drocodone, the most widely-prescribed painkiller, were subjected to new, stricter federal prescribing rules. The new regula- tions recommended by the Food and Drug Administration and published by the U.S. Drug Enforcement Administra- tion, made medications that contain opioid subject to the same restrictions as other narcotics such as oxycodone and morphine.21
This is an example of how
intelligent regulations may help reduce the likelihood that patients become ad- dicted to powerful narcotics.
Leverage the power of healthcare technology to empower better care. The industry now has mobile apps that track medications and remind individu- als to take pills in accordance to clini- cian directives. But there is also growing utilization of more sophisticated health IT tools that help physician group ad- ministrators and health plans to identify clinicians who appear to be outside the
70 datia focus
norm in prescribing pain medications, and patients that appear to have inappro- priate utilization. Similarly, the Office of the National Coor-
dinator for Health Information Technology and the Substance Abuse and Mental Health Services Administration funded pilot studies that improved the integration of PDMPs into provider workflow and other health records systems. Tese pilot programs show great promise. Te Indiana Network for Patient Care leveraged its secure hospital network to offer information from the state PDMP along with a “narcotic score” alert to emergency department doctors as part of their normal view of a patient’s record. Under a pilot program in Kansas, a secure email protocol sends a PDMP report to a patient’s electronic health record when a certain threshold is met, such as when the patient sought to fill five prescriptions from five providers during one calendar quarter.22 So, have our tools kept pace with the evolv-
ing face of drug misuse? We may not have turned the tide, but we are employing new strategies to help us combat the epidemic. In President Richard Nixon’s 1971 mes-
sage to Congress on drug abuse prevention and control efforts, he declared, “We are not without some understanding in this mater, however…and we are not without the will to deal with this mater. We have the moral resources to do the job…but time is critical. Every day we lose compounds the tragedy which drugs inflict on individual Americans.” Sadly, those words are still relevant, 45 years later. But it is also true that there is much we can do to ensure that prescription drugs foster good health, not harm, for our patients.
Endnotes
1 H. H. Kane, Opium Smoking in America and China (New York, 1882), cited in Terry and Pellens, p. 73
2
http://www.cfr.org/drug-trafficking-and-control/ harrison-narcotics-tax-act-1914/p27928
3
http://www.drugpolicy.org/new-solutions-drug-policy/ brief-history-drug-war
4
http://www.dea.gov/druginfo/ds.shtml 5
http://www.dare.com/home/about_dare.asp
6 New York Times/CBS News poll, 9/6-9/8, 1989
7 Rational Use of Opioids for Management of Chronic Nonterminal Pain, Daniel Berland, MD, and Phillip Rodgers, MD, University of Michigan Medical School, Ann Arbor, Michigan, Am Fam Physician. 2012 Aug 1;86(3):252-258
8
http://www.whitehouse.gov/sites/default/files/ondcp/ policy-and-research/rx_abuse_plan.pdf
9
http://www.whitehouse.gov/ondcp/prescription-drug-abuse
10
http://www.drugabuse.gov/related-topics/trends- statistics/infographics/popping-pills-prescription-drug- abuse-in-america
11
http://www.whitehouse.gov/sites/default/files/ ondcp/Fact_Sheets/prescription_drug_abuse_fact_ sheet_4-25-11.pdf
12
http://www.samhsa.gov/data/sites/default/files/ NSDUHresultsPDFWHTML2013/Web/
NSDUHresults2013.htm
13
http://www.cdc.gov/mmwr/preview/mmwrhtml/ mm6043a4.htm
14
http://www.whitehouse.gov/ondcp/prescription-drug-abuse
15
http://www.questdiagnostics.com/home/physicians/ health-trends.html
16
http://www.drugpolicy.org/docUploads/FactSheet_ National_War_on_Drugs.pdf
17 Institute of Medicine Report from the Committee on Advancing Pain Research, Care, and Education: Relieving Pain in America, A Blueprint for Transforming Prevention, Care, Education and Research. The National Academies Press, 2011.
18
http://www.questdiagnostics.com/dms/Documents/ health-trends/2014_health_trends_prescription_drug_ misuse.pdf
19
http://www.cms.gov/Medicare-Medicaid- Coordination/Fraud-Prevention/Medicaid-Integrity- Education/Downloads/prescriptiondrug-monitoring- factsheet.pdf
20
http://www.questdiagnostics.com/dms/Documents/ health-trends/2014_health_trends_prescription_drug_ misuse.pdf
21
http://www.deadiversion.usdoj.gov/drug_chem_info/ hydrocodone.pdf
22
http://www.healthit.gov/sites/default/files/connecting_ for_impact-final-508.pdf
F. Leland McClure, MSci, PhD, D-ABFT, is Director, Pain Management for Quest Diagnostics, the world’s leading provider of diagnostic information
services. The company offers tests and services to aid clinicians in monitoring patients for appropriate use of up to 26 commonly abused prescription medications, such as opioids and sedatives, and illicit drugs, such as marijuana and cocaine, as well as a full line of lab-based and instant drug testing products and services through Quest Diagnostics Employee Solutions that provide the critical information employers need to make informed decisions.
spring 2015
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