Prescription drug overdoses have double while many states with strategies ignore the problem
In the past twenty years biomedical research had made many advances that include new treatments for pain, ADHD, anxiety and sleep disorders. However, while these advances are increasing so is the misuse or abuse of prescription drugs especially when it comes to painkillers that have negative health outcomes and even death, this the latest from a new report Prescription Drug Abuse: Strategies to Stop the Epidemic by the Trust for America's Health (TFAH).
According to the new report prescription drug over dose deaths had doubled in 29 states since 1999. These deaths are now higher than those from heroin and cocaine combined and these prescription drug overdose deaths surpass the number of motor vehicle related deaths in 29 states and Washington, D.C.
In order to create the policy report card on the 50 states and the District of Columbia the authors reviewed a range of national recommendations for policies to curb prescription drug abuse. Following that review the authors established a set of indicators that were based on laws and policies found to be successful at stopping abuse in order to rate each state. These indicators had included the use of prescription drug monitoring programs, existence of "doctor shopping" laws, prescriber education requirements, and support of naloxone, a medication called an “opioid antagonist” used to counter the effects of opioid overdose, for example morphine and heroin overdose.
The report found more than 70,000 children goes to the emergency department each year due to medication poisoning every year. In many of these cases the poisoning is due to the child taking the adults medication. Children seeking treatment for drug poisoning is double the rate compared to poisoning from household products.
Visits to the emergency room for prescription drug abuse almost doubled between 2004 and 2011. The most commonly involved drugs included antianxiety and insomnia medications and prescription painkillers (160.9 and 134.8 visits per 100,000 populations, respectively).
Also found were high costs of Medicaid due to fraudulent or abusive purchases of controlled substances. A 2009 Government Accountability Office (GAO) investigation found tens of thousands of Medicaid beneficiaries and providers involved in potential fraudulent purchases of controlled substances, abusive purchases of controlled substances, or both, through the Medicaid program in California, Illinois, New York, North Carolina, and Texas.
Dr. Jeff Levi, PhD, Executive Director of the Trust for America’s Health commented in a release "The rapid rise of abuse requires nothing short of a full-scale response, starting with prevention and education all the way through to expanding and modernizing treatment.” "There are many promising signs that we can turn this around, but it requires urgent action."
According to the report TFAH in consultation with a number of public health, clinical, injury prevention, law enforcement and community organization experts had reviewed a collection of national recommendations and examined a set of 10 indicators of strategies being used in states to help curb the epidemic. There are indications that some of these efforts and strategies may be having a positive impact, the number of Americans abusing prescription drugs decreased from 7 million in 2010 to 6.1 in 2011, according to the National Survey on Drug Use and Health.
Key findings from the report card include;
Appalachia and Southwest Have the Highest Overdose Death Rates: West Virginia had the highest number of drug overdose deaths, at 28.9 per every 100,000 people – a 605 percent increase from 1999, when the rate was only 4.1 per every 100,000. North Dakota had the lowest rate at 3.4 per every 100,000 people. Rates are lowest in the Midwestern states.
Doctor Shopping Laws: Every state and Washington D.C. has a law making doctor shopping illegal.
Rescue Drug Laws: Just over one-third of states (17 and Washington, D.C.) have a law in place to expand access to, and use of naloxone.
Physical Exam Requirement: 44 states and Washington, D.C. require a healthcare provider to either conduct a physical exam or screen for signs of substance abuse or have a bona fide patient-physician relationship that includes a physical exam prior to prescribing.
ID Requirement: 32 states have a law requiring or permitting a pharmacist to require an ID prior to dispensing a controlled substance.
Pharmacy Lock-in Programs: 46 states and Washington D.C. have a pharmacy lock-in program under the state’s Medicaid plan where individuals suspected of misusing controlled substances must use a single prescriber and pharmacy.
Professor Andrea Gielen, ScD, Director of the Johns Hopkins Center for Injury Research and Policy, commented in a release "We must use the best lessons we know from other public health and injury prevention success stories to work in partnership with clinical care, law enforcement, the business community, community-based organizations, and other partners to work together to curb this crisis.”
Key recommendations from the report include:
Educate the public to understand the risks of prescription drug use to avoid misuse in the first place
Make sure patients do receive the pain and other medications they need, and that patients have access to safe and effective drugs
Expand access to and availability of effective treatment options as a key component of any strategy to combat prescription drug abuse.
In conclusion the authors write “This report features important information to the broad and diverse groups involved in this issue; encourages greater transparency and accountability; and outlines promising recommendations to ensure the system addresses this critical public health concern.”