Prescription drug monitoring programs are now being used extensively in several American states, but there is a dearth of data on their effectiveness in curbing the number of opioid overdoses, as found out by a recent study. The rationale behind using these programs is to prevent the replication or overlapping of prescriptions for opioids – the practice commonly known as doctor shopping.
Chris Delcher, from the department of health outcomes in the University of Florida College of Medicine, said that it is important to understand if these programs are helping in any way by curbing the fatal and non-fatal overdoses. According to him, in an era where the changes are being made and implemented at the federal level to combat the opioid epidemic, it is natural to assess the utility of such programs.
Delcher and his team published their findings in the journal Annals of Internal Medicine in May 2018. The study was sponsored jointly by the Bureau of Justice Assistance and the National Institute on Drug Abuse (NIDA) and it was led by the scientists from the University of California, Davis and the Columbia University.
The team of researchers investigated as many as 2,600 scientific publications and found that only 10 linked prescription drug monitoring programs to overdoses. Even in these 10 studies, the team found an exceedingly low evidence of the effectiveness of the programs in reducing fatal overdoses, leading to inconclusive outcomes.
The study authors came across some surprising findings. Three studies showed that after the implementation of the prescription drug monitoring programs, there was a rise in overdose-related deaths due to heroin. A 2013 study showed that in Philadelphia and San Francisco, there was a transition from prescription drugs to heroin because of the latter’s easy accessibility and cheap cost.
Moreover, in 2011 in Florida, after the implementation of the program, the number of overdoses dropped due to oxycodone, but there was a concomitant rise in overdoses related to fentanyl, heroin and morphine. Delcher explained this by stating that crackdown on prescription opioids facilitates transition to other drugs.
The researchers found three parameters from the prescription drug monitoring programs that impacted the number of fatal overdoses. These were:
Reviw of patient’s medical history by the doctors before writing a prescription.
Increase in frequent updation of patient’s prescription data.
Increased accessibility of patient data to the providers.
Delcher shared that investigating the efficay of the prescription drug monitoring tool is one of the ways to improve its efficiency and usability. He said that the tool could be made more refined and spontaneous so that it comes handy to the busy physicians, and they are better able to classify patients’ risk of misuse, abuse or overdose. Delcher is presently striving to improve the patient-risk algorithms, overlying medication dashboards, and other data-influenced methods to enhance the database.
Opioid overdose deaths on the rise
Nearly 350,000 people succumbed to opioid overdose – both prescription and illicit – between 1999 and 2016. The overdose-related deaths manifested through three phases:
The first phase began in 1999 when the prescriptions for opioids increased (methadone, natural and semi-synthetic opioids).
The second phase commenced in 2010 when overdose deaths increased due to heroin.
The third phase began in 2013 when overdose related fatalities increased due to fentanyl. Many times, fentanyl is laced with heroin and cocaine, and sold in counterfeit pills.
Road to recovery
Addiction usually begins from a prescription and when the prescription runs dry, people fuel their addiction through illicit drugs. These drugs can have a catastrophic effect on every area of one’s life. Thus, one should take drug abuse help from a good drug abuse clinic before it is too late.