The Opioid Epidemic - When Prescriptions Become the Problem

Recently, CRC has been working with several clients who are evaluating initiatives to combat substance misuse and abuse. In particular, these agencies have been concerned with how their local communities have been impacted by the problem of drug overdoses and opioid-involved deaths, which have markedly increased in the United States over the past decade (CDC.gov).

More than six out of ten drug overdose deaths involve an opioid, and The Centers for Disease Control and Prevention estimates that 91 Americans die every day from an opioid overdose (Rudd, Seth, & Scholl, 2016). In this interactive quiz from the New York Times, you can place the opioid epidemic in deeper context, seeing just how steep the rise has been, by drawing the trends in deaths from guns, the HIV epidemic, car accidents, and drug overdoses.

Prescription opioids Prescription opioids are usually used to treat moderate-to-severe pain and are often prescribed after surgery, injury or for severe health conditions such as cancer. Even though there is a lack of evidence about the long-term effectiveness in the use of prescription opioids for the treatment of chronic pain, many providers continue to use them as a first line of treatment instead of trying alternative therapies first. In 2013 alone, providers wrote nearly 250 million opioid prescriptions, enough for every American adult to have their own bottle of pills (IMS Health, National Prescription Audit). The reality is anyone who takes prescription opioids can become addicted to them. In fact, as many as one in four patients receiving long-term opioid therapy in a primary care setting struggles with opioid addiction.

How can prescribers help in mitigating the opioid epidemic? The use of Prescription Drug Monitoring Programs (PDMPs) can help medical providers make more informed decisions when prescribing opioids for their patients. PDMPs are state-run electronic databases used to track the prescribing and dispensing of controlled prescription drugs to patients (CDC.gov). Pharmacists and other providers can use PDMPs to access a patients drug history and identify high-risk patients who would benefit from early interventions.

How can we encourage providers to use the PDMP? One of the ways providers can be encouraged to use PDMPs is to make sure that the systems are easy to access and use during patient engagement. CRC is working with the Delaware Department of Health to implement a PDMP end-user survey to get input from pharmacists and other providers on features they would like to be added or improved in the Delaware PDMP system.

Looking to implement a similar survey in your work? Oregon State did a great job on their PDMP survey and wrote a journal article about it: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4079731/

Learn more about the opioid epidemic with these resources: CDC Guidleine for patients CDC Guideline for Prescribers