Prescription Medicine Abuse

Prescription drug abuse, and in particular opioid addiction, is reaching a crisis level in the country.

The statistics and numbers are frightening; drug overdoses, driven largely by the use of prescription opioids and illicit drugs like heroin and illegally made fentanyl, are now the leading cause of injury death in the United States, at nearly 44,000 per year. From 1999 to 2014, more than 165,000 people died from overdoses related to prescription opioids, according to The Facts Hurt: A State-by-State Injury Prevention Policy Report.

You are in a unique position in this crisis. Not only do you prescribe medications, you can start the conversation to help prevent or identify abuse of prescription drugs and possibly prevent escalation to addiction.

Conversation points to consider having with patients:

• Discuss alternative pain treatment options. Talk about the risks and benefits of all treatment options.
• Advise patients not to leave prescription bottles lying around to tempt children and teens. Seventy-five percent of young people who have abused prescription pain medicines have gotten them from a family member or friend, according to Prescription Drug Abuse Up Among Teens: Survey. Properly store medications and keep them locked.
• Inform patients that they should not keep unused medications. Strongly encourage patients to dispose of medications properly. Refer your patients to their local community drop-off locations or have them talk to their pharmacists on how to dispose of unused medications.

Advise patients to properly store medications and keep them locked.

Advise patients to visit the Pennsylvania Department of Drug and Alcohol Programs’ website to find permanent drug take-back collection sites in their area.

When pain management treatment is appropriate, consider following the Centers for Disease Control and Prevention’s (CDC’s) recommendations and guidelines for prescribing opioids for chronic pain:

Use non-opioid therapies, such as an anti-inflammatory.
Opioids are not first-line or routine therapy for chronic pain.

Start low and go slow.
When starting opioids, prescribe them at the lowest effective dose.

Follow up.
Evaluate benefits and harms with patients within one to four weeks of starting; reduce dose or taper and discontinue.

To read the complete guidelines, visit the Centers for Disease Control and Prevention (CDC) website.

Information and resources

Register now for and query the Pennsylvania Prescription Drug Monitoring Program (PA PDMP).

All Schedule II-V dispensed prescriptions must be reported to the PDMP system within 72 hours of being dispensed. The PDMP provides data to health care professionals to enable them to make more informed decisions about prescribing and dispensing monitored prescription drugs to their patients or potential patients.

• Prescribers are required by law to search the PDMP for each patient when the patient is prescribed a controlled substance for the first time and/or when there is clinical concern the patient may be suffering from the disease of addiction or diverting a controlled substance(s).

For complete details and registration access, visit the Pennsylvania Department of Health website.