'A lot to do' to change painkiller prescribing, researcher says
Opioid prescribing fell with physician drug-monitoring
The launch of drug-monitoring programs in 24 states led to an immediate 30 per cent drop in prescriptions for Schedule II opioids, the most addictive, in patients with pain complaints, the study showed.
Bao, a health economist at Weill Cornell Medical College in New York, and colleagues analyzed 26,275 office visits for pain in 24 states that implemented prescription drug-monitoring programs from 2001 to 2010.
Given how many people are killed by prescription opioids and how dangerous these drugs are, it should be no less important for a clinician to check a prescription drug-monitoring program before prescribing an opioid than to check kidney function before prescribing a new blood-pressure medicine.- Dr. Caleb Alexander
The study confirmed Bao's hypothesis that physician drug-monitoring programs, which have been implemented in a wide variety of forms in every state except Missouri, are an effective tool to combat the opioid drug epidemic. But she stressed the need for other means as well.
"The interventions are needed along the continuum here — from manufacturers to end-users. This is important to keep in mind given the magnitude of addiction, injuries and deaths," said Alexander, who was not involved in the current study.
Overdose deaths, along with sales of prescription opioids, have quadrupled since 1999, the CDC estimates. More than 165,000 Americans died from overdoses related to prescription opioids from 1999 to 2014.
No opioid is entirely safe
A database could show when patients are obtaining opioids under their own name from multiple doctors, which might assist in identifying potential abuse and dependency, he noted.
Drug-monitoring databases may make doctors think twice before prescribing pain medications for a variety of reasons in addition to uncovering "doctor shopping" by patients, the study authors write.
Knowing that they're being watched may serve as a deterrent, and the programs may generally increase awareness of the dangers of prescribing opioids, they say.
In March, the CDC released guidelines instructing primary care doctors to sharply curtail use of opioids for chronic pain.
At the time, CDC Director Dr. Tom Frieden called the prescription overdose epidemic "doctor-driven."
Authors of the current study say American clinicians are writing enough prescriptions to medicate every U.S. adult for a month.