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Tag Archives: drug monitoring program
A major doctors’ organization is urging its members to practice greater caution and restraint when prescribing prescription painkillers in light of the abuse epidemic. The American College of Physicians said in a policy letter published in the Annals of Internal Medicine that prescription drug abuse is a “serious public health problem” and that physicians and other health professionals with prescribing privileges play an important role in helping to ensure safe and effective use of drugs like OxyContin and Vicodin.
According to the group, evidence-based, nonbinding guidelines should be established regarding recommended maximum dosage and duration of therapy that a patient taking controlled substance medications may receive.
In addition, the ACP called for the establishment of a national prescription drug monitoring program to help doctors detect and prevent prescription drug abuse by identifying individuals who seek to obtain prescriptions for addictive medications from multiple physicians for themselves or to sell. Former President George W. Bush launched an initiative in 2005 authorizing federal grants for states to establish or enhance PDMPs, the group said, but funding was initially delayed and has been inconsistent.
Forty-nine states have taken measures to implement prescription drug monitoring databases in light of the pill addiction epidemic, but Missouri lacks such a program — despite the fact that it has the seventh highest drug overdose death rate in the country, a majority of which are from prescription drugs, according to this article.
Approximately 3,200 people in Missouri seek treatment for a prescription drug abuse problem each year, and the most commonly used drugs were controlled substances such as Xanax, OxyContin, and Vicodin, the article says, pointing to data from the Missouri Department of Mental Health. Yet efforts to establish a prescription drug monitoring program were stymied when a Missouri senator filibustered the legislation that would have brought the database to the state, citing concerns over patient privacy, the article says.
The U.S. Centers for Disease Control and Prevention recently found that drug overdose deaths increased for the eleventh consecutive year in 2010. According to the agency, 38,329 people died from a drug overdose in the U.S. that year, up from 37,004 deaths in 2009.
Overdose deaths involving opioid analgesics have shown a similar increase, the CDC found: starting with 4,030 deaths in 1999, the number of deaths increased to 15,597 in 2009 and 16,651 in 2010.
The California Senate has given the green light to two bills aimed at combatting prescription drug abuse and overdose deaths by helping authorities track painkiller prescriptions and enabling enhanced scrutiny of deaths involving such drugs.
The proposed legislation would require coroners to report prescription overdose deaths to the state’s medical board for review, according to the Los Angeles Times, which earlier reported on the nearly 4,000 accidental deaths involving prescription drugs in Southern California and found that in half the cases, drugs that caused or contributed to a death had been prescribed by that person’s physician.
The legislation would also enhance and provide sustained funding for California’s prescription drug monitoring system, known as CURES, which contains detailed data on prescriptions for painkillers, the LA Times said.
The two bills now head to the desk of Gov. Jerry Brown for approval.
Heroin use and overdose deaths have skyrocketed in recent years, and emerging information suggests this is the result of prescription painkiller addicts transitioning to the hardcore street drug. According to statistics recently released by the National Center for Biotechnology Information, most people reporting heroin use initially started on pills.
According to the NCBI:
Between 2002-2004 and 2008-2010, past year heroin use increased among people reporting past year nonmedical use (PYNMU) of opioid pain relievers, but not among those reporting no PYNMU. Frequent nonmedical users – people reporting 100-365 days of PYNMU – had the highest rate of past year heroin use and were at increased risk for ever injecting heroin and past year heroin abuse or dependence as compared to infrequent nonmedical users (1-29 days of PYNMU).
In 2008-2010, 82.6% of frequent nonmedical users who used heroin in the past year reported nonmedical use of opioid pain relievers prior to heroin initiation compared to 64.1% in 2002-2004.
The California Senate has given the stamp of approval to a package of bills aimed at reducing prescription drug abuse and overdose deaths, including a measure that would require coroners to report deaths involving prescription drugs to the Medical Board of California. The Los Angeles Times reports that the Senate also signed off on a bill that would upgrade the state’s prescription drug monitoring program, known as CURES. In addition, lawmakers approved a measure that would make it easier for the medical board to investigate physicians suspected of overprescribing and suspend their prescribing privileges, and a bill that would prohibit pharmacies from advertising commonly abused narcotic medications, such as OxyContin and Vicodin, according to the LA Times.
The package of legislation will now move on to the California Assembly for approval.
The CURES bill faced the strongest opposition from the pharmaceutical and biotech industries, the Times says, even though it had the support of a coalition of law enforcement groups, health insurance companies, and business, labor and consumer organizations. That opposition was dropped after the bill’s sponsors removed a provision that called for a tax on drug makers to pay for teams of investigators to crack down on drug-seeking patients and doctors who recklessly prescribe to them, according to the Times.
The Minnesota Medical Association is considering requiring doctors to take continuing education courses on pain management and addiction and increasing use of the Minnesota Prescription Monitoring Program in order to deal with the state’s prescription drug abuse issue, according to this article. As of March 2013, only 40% of pharmacists and 30% of doctors in Minnesota were using the monitoring system, according to the article.
Georgia’s new prescription drug monitoring database, which is set to become operational in June, may run out of the money it needs to operate soon after its implementation because lawmakers failed to appropriate any funding for the program when they passed legislation to create it in 2011, according to the Atlanta Journal-Constitution.
A two-year, $400,000 federal grant that pays startup costs for a new prescription monitoring program grant expires Sept. 30, the paper says.
In Georgia — which is among the last six states in the nation to put a prescription monitoring program in place, according to the National Alliance for Model State Drug Laws — prescription drug abuse causes or contributes to the overdose deaths of 11 people every week.
A California Senate committee has given the stamp of approval to a package of bills aimed at reducing prescription drug abuse and overdose deaths, including a measure that would require coroners to report deaths involving prescription drugs to the Medical Board of California. The Los Angeles Times reports that the committee also signed off on a bill that would upgrade the state’s prescription drug monitoring program, known as CURES. In addition, the committee approved a measure that would make it easier for the medical board to investigate physicians suspected of overprescribing and suspend their prescribing privileges, and a bill that would prohibit pharmacies from advertising commonly abused narcotic medications, such as OxyContin and Vicodin, according to the LA Times.
Before moving to the Senate floor, all four bills must clear additional committees, the Times said.
The Times recently issued a report finding that the California Medical Board has repeatedly failed to protect patients from reckless prescribing by doctors: it rarely tries to suspend the prescribing privileges of doctors under investigation, and even when it imposes sanctions, in most cases it allows doctors to continue practicing and prescribing. The Times’ examination of board records and county coroners’ files from 2005 through 2011 found that eight doctors disciplined for excessive prescribing later had patients die of overdoses or related causes; prescriptions those doctors wrote caused or contributed to 19 deaths.
Iowa has taken an interesting approach towards stopping the practice of seeking out multiple doctors for painkiller prescriptions with a program that “locks” Medicaid recipients into using one doctor, one pharmacy and one hospital. And according to this article, the program appears to be having some positive results: by locking in more patients, the state saved $14.8 million from July 2010 through September 2012 in the cost of drugs and doctors’ visits.
The number of “locked-in” Iowa Medicaid recipients has increased sevenfold from 200 in 2010 to 1,430 in January, the article says, a jump that came after Iowa Medicaid started screening patients not for just doctor-filled prescriptions, but for non-emergency visits to hospital emergency rooms.
The state’s prescription drug monitoring program was launched in March 2009, but only one-quarter of Iowa doctors and prescribers are registered to use the database, which includes more than 4.2 million prescriptions annually, the article says.
Prescription painkillers caused 62 deaths in Iowa in 2011, up from just four deaths in 2000, while prescription abuse treatment admissions more than quadrupled from 187 in 1999 to 878 in 2009, according to the Iowa Department of Public Health.
Like many states, North Carolina has implemented a prescription drug monitoring database to identify people who abuse and misuse powerful painkillers. Now, a new study at the University of North Carolina at Chapel Hill shows that the system – which is voluntary – is only used by about one-third of the 34,000 physicians who are registered with the Drug Enforcement Agency to prescribe controlled substances – and fewer than half of those registered actually used it in the last six months of 2011.
However, at the same time, the number of patients with the most severe drug-seeking behaviors – those who used 10 prescribers and 10 pharmacists within six months – decreased substantially from 217 in 2008 to 115 in 2012, the study found.
Prescription drug overdose kills an average of three people per day in North Carolina.
Nearly all states have operational prescription drug monitoring programs, with the exception of Montana, Nebraska, Arkansas, Wisconsin, Georgia, Maryland, New Hampshire, and the District of Columbia, according to the latest research from the Alliance of States with Prescription Monitoring Programs.