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State Prescription Database May Help Curb Opioid Abuse.

Posted Dec 23 2008 9:14pm
An interesting approach to narcotic abuse by patients was recently studied by the University of Michigan and University of Ohio using a clinic in Ohio. Providers established a registry of abusers and potential abusers that violated rules for narcotic use. Forbes ran the story on the 9th of April.

The report describes how patients were screened for narcotic use prior to a clinic appointment utilizing the state’s prescription database. The database information told clinic personnel if the patient had received other prescriptions recently from another provider. This would show if the patient was shopping for narcotics. Additionally patients were given random urine toxicology exams to see if they were using other illicit drugs which would put them at high risk for abusing prescription pain medicine. The clinic found that 37 percent of their patients had in some way violated the rules of opioid use and were placed on an abuser registry. Once the clinic identified a patient as an abuser or potential abuser they offered treatment to them. The article didn’t provide details about the success rate if any with abusers and their detox / rehab program.

Narcotic and illicit drug addiction is a highly pervasive problem that all healthcare organizations or any size deal with on a daily basis. Through my years of working in emergency departments and speaking with both nursing and physician colleagues in various parts of the country the names change but the stories are the same. Drug abuse is prevalent across many age groups both young and old. Alcohol, Heroin, Methamphetamine, Oxycontin, and Cocaine are but a few of the favorite substances that patients use.

It’s good to see endeavors such as the one in Ohio doing what they can to identify abusers and offer treatment. The Ohio clinic setting allows them the controlled environment to undertake the investigative process that they have to weed abusers out of the pack. The down side is that once these patients know that they have been identified and are not going to be able to obtain controlled prescriptions, they move else where, such as the local emergency department were conditions are less conducive to allowing the time needed to conduct the same background check that the clinic does.

In that the Ohio study has limited application to other healthcare settings, it does offer a good tool that could be utilized by each state to help thwart abusers from obtaining prescription pain medications in all healthcare settings. That tool is the state prescription data base. If all states developed a prescription database and made that information available to physician providers and mid-level providers that have prescriptive authority patients could be readily identified as abusers and alternative treatment options offered to them.

The healthcare costs associated with drug abuse are enormous. Those patients that present to healthcare facilities with the intent of obtaining opioids for recreational purposes only add to the patient crowding that already occurs in these settings. They squander precious resources to include provider time that can be spent more appropriately with other ill and injured patients. The other aspect that is seen in the emergency department setting more than others is the potential for these people to become violent when they don’t receive there drugs.

I would say that the Ohio / Michigan study has merit and can be exported to other healthcare settings across the country to help mitigate the abuse of prescription medications.
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