Pubdate: Mon, 13 Oct 2014 Source: Columbia Daily Tribune ( MO ) Copyright: 2014 Columbia Daily Tribune Contact: http://www.columbiatribune.com/ Details: http://www.mapinc.org/media/91 Author: Nathanial S. Nolanmissouri Note: Nathanial S. Nolan is a student in the University of Missouri School of Medicine. MISSOURI MUST MONITOR PRESCRIPTION DRUG SALES Over the past two decades a silent epidemic has swept the nation, killing tens of thousands of people. The health care industry is quietly battling the problem of prescription drug abuse but has yet to make substantial progress. The release of long-acting opioid pain medications by drug companies has led to their use in the management of chronic pain. Though the management of chronic pain is not a direct misuse of the drug, the U.S. has seen a dramatic rise in opioid prescriptions: 402 percent between 1997 and 2007. As a third-year medical student, I see the significant problem this poses for physicians. Drugs prescribed with the best intent, for what physicians believe to be real health problems, become easily diverted, which is a nice way of saying the drugs are sold for recreational use. A 2010 study found that 6 of the top 10 substances abused by seniors in high school were pharmaceuticals. This abuse has become so severe that deaths from prescription drug overdose rose by 118 percent from 1999 to 2011. These numbers have helped drug overdose become the leading cause of injury-related death, beating out motor vehicle accidents. Over the past two decades a silent epidemic has swept the nation, killing tens of thousands of people. The health care industry is quietly battling the problem of prescription drug abuse but has yet to make substantial progress. The release of long-acting opioid pain medications by drug companies has led to their use in the management of chronic pain. Though the management of chronic pain is not a direct misuse of the drug, the U.S. has seen a dramatic rise in opioid prescriptions: 402 percent between 1997 and 2007. As a third-year medical student, I see the significant problem this poses for physicians. Drugs prescribed with the best intent, for what physicians believe to be real health problems, become easily diverted, which is a nice way of saying the drugs are sold for recreational use. A 2010 study found that 6 of the top 10 substances abused by seniors in high school were pharmaceuticals. This abuse has become so severe that deaths from prescription drug overdose rose by 118 percent from 1999 to 2011. These numbers have helped drug overdose become the leading cause of injury-related death, beating out motor vehicle accidents. There are many mechanisms being developed to combat the misuse of prescription drugs. One widely adopted method is prescription drug monitoring programs. These are electronic databases, used by pharmacists and physicians, that keep track of who picks up what drugs, who prescribed them and when. Recently Missouri has been called "a haven for prescription drug addicts" because it is the only state that does not have such a monitoring program in place. In fact, this summer Missouri was the subject of an in-depth investigation by The New York Times, which highlighted how specific legislators have killed attempts to build such a system. When entering practice, physicians are sworn to "do no harm," and the vast majority practice with that mindset. However, doctors in Missouri are currently practicing blind. Without a monitoring system in place, a physician has no idea that patient X might be seeking care at three separate clinics for his or her back pain, all of which prescribe him or her narcotics. This is not an improper use of such drugs on the part of the physician, but not knowing what your patients are already being prescribed is an injustice to clinicians, placing them at a disadvantage. There is evidence that Missouri's problems are bleeding into neighboring states. Many individuals have been arrested for crossing into Missouri to fill their prescriptions, which essentially bypasses their own state's monitoring program. National news outlets have also pointed out that a number of pain clinics are popping up suspiciously close to Missouri's borders. Ultimately, Missouri is doing a poor job to curb prescription drug abuse. It has the seventh-highest overdose mortality rate of the entire United States, and according to a recent Report on Prescription Drug Abuse, Missouri scored 3 out of 10 on its regulatory actions -- the second-lowest score of all 50 states. Legislative action against prescription drug abuse can work. Florida, a state that had notoriously high rates of prescription drug abuse, reported that between 2010 and 2012 there was a 23 percent decrease in prescription drug overdoses due to new statewide regulations. One of these government interventions was a prescription drug monitoring program. Other states have reported similar success with their drug monitoring programs, which raises the question: Why doesn't Missouri have one? This question is being asked by Missouri's chapter of the American College of Physicians, whose council readily endorsed such a program. In a few short years I will be a physician practicing in the state of Missouri. I cannot imagine how devastating it would be to unknowingly contribute to a patient's addiction and possible demise. Though monitoring programs will not totally remove the threat of abuse and addiction, they can give medical practitioners the knowledge to make sound prescribing decisions. The state of Missouri and its physicians need a prescription drug monitoring program to effectively battle this problem. Ultimately, thousands of lives might be saved by it. - --- MAP posted-by: Richard