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Massachusetts fights opiate epidemic

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The Commonwealth continues to try to ban distribution of a new prescription drug that is said to be 5 times as potent as Vicodin, a painkiller that is already available on the street and noted as a key contributor to the current “opiate epidemic”.

A Federal judge last week overturned the state ban, promoted by Governor Deval Patrick, opining that the state did not have jurisdiction over the Federal Food and Drug Administration, which approved the sale and distribution of Zohydro.

Zohydro is in the same class of drugs as Oxycontin, Percocet, Vicodin and Methadone, all potent painkillers. This drug class, known as opiates, creates effects similar to heroin. It is these drugs, readily available by prescription from many doctors and dentists that are ending up on the streets as extra supplies are stolen from family medicine cabinets, sold by people who have more than needed or are obtained by people who “doctor shop” to obtain the prescriptions simply to sell. As use of these pills, which create feelings of euphoria in low doses, quickly become expensive, many people graduate to use of heroin which is cheaper and easily obtainable in the Northeast.

In response to the Federal court’s overturn of the state ban, the Massachusetts state Board of Registration in Medicine is enacting a requirement that prescribers of Zohydro must first complete a risk assessment and pain management treatment agreement with each patient before prescribing the drug. Many risk assessment formats exist, some more comprehensive than others. It is unclear at this time what format will be required or if prescribers will be left to choose a format on their own. Prescribers will also be required to participate in the Prescription Monitoring Program which has been enacted to monitor prescription and use of drugs of potential abuse such as the opiates.

A web site from the United Kingdom provides a comprehensive assessment format. In the United States the Substance Abuse and Mental Health Services Administration (SAMHSA) recommends a number of different assessment tools including the DAST-10 and NIDAMED for doctors. Responsible prescription and use of Zohydro will only occur if adequate screening tools are utilized. If not, the opiate epidemic will grow proportionally.

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