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Study shows urgent need for improved opioid prescribing practices

Information from state prescription drug monitoring programs can be used to detect and measure prescribing patterns that suggest abuse and misuse of controlled substances, according to a report released Oct. 15 in the CDC’s Morbidity and Mortality Weekly Report Surveillance Summary.
Such information could help reduce abuse of narcotic painkillers and deaths resulting from the narcotics, according to the report.

“Every day, 44 people die in American communities from an overdose of prescription opioids, and many more become addicted,” CDC Director Tom Frieden, MD, MPH, said in a news release. “States are on the frontline of witnessing these overdose deaths. This research can help inform their prescription overdose prevention efforts and save lives.”

Drug overdose is the leading cause of injury death in the U.S., mostly due to abuse and misuse of prescription opioid pain relievers, benzodiazepines (sedatives/tranquilizers) and stimulants, according to the news release.

The multi-state report from the CDC- and FDA-funded Prescription Behavior Surveillance System analyzes data from monitoring programs in California, Delaware, Florida, Idaho, Louisiana, Maine, Ohio and West Virginia. Those states represent about a quarter of the U.S. population. The study found prescribing practices varied widely among states despite the fact that states are similar in the prevalence of the conditions these drugs are used to treat. Moreover, differences in population characteristics, such as ethnicity and social status, likely explain only a fraction of the variation in prescribing practices. The findings point to the urgent need for improved prescribing practices, particularly for opioids – which in all eight states were prescribed twice as often as stimulants or benzodiazepines.

Prescribing rates varied widely by state: twofold for opioids, fourfold for stimulants, and nearly twofold for benzodiazepines. The study also found a small minority of prescribers are responsible for most opioid prescriptions. The top 1% of prescribers wrote 1 in 4 opioid prescriptions in Delaware, compared with 1 in 8 in Maine. People who receive opioid prescriptions often receive benzodiazepine prescriptions as well, despite the risk for adverse drug interactions. The percentage of controlled substance prescriptions paid for in cash — an indicator of abuse — varied almost threefold among five states reporting this measure.

“A more comprehensive approach is needed to address the prescription opioid overdose epidemic, including guidance to providers on the risks and benefits of these medications,” Debra Houry, MD, MPH, director of CDC’s National Center for Injury Prevention and Control, said in the release.

The CDC works with states, communities and prescribers to prevent opioid misuse and overdose by tracking and monitoring the epidemic and helping states scale up effective programs such as the Prescription Drug Overdose: Prevention for States program. Learn more at www.cdc.gov/DrugOverdose.

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By | 2020-05-05T03:03:55-04:00 October 27th, 2015|Categories: Nursing news|4 Comments

About the Author:

Sallie Jimenez
Sallie Jimenez is content manager for healthcare for Nurse.com published by Relias. She develops and edits content for the Nurse.com blog, which covers industry news and trends in the nursing profession and healthcare. She also develops content for the Nurse.com Digital Editions. She has more than 24 years of healthcare journalism, content marketing and editing experience.

4 Comments

  1. Avatar
    Dave October 27, 2015 at 5:10 pm - Reply

    The CDC’s approach to the problems with opioid diversion fail to recognize the role poor pain care plays in the “opioid epidemic”. Opioids are overprescribed and underprescibed and diverted in part due to doctors and patients lack of knowledge of alternatives. The CDC is aware of the National Pain Strategy-and that the NPS only specific treatment mentioned was opioids. So in addition to lack of education and knowledge of alternatives- the creators of the NPS-and their front groups are very enthusiastic when it comes to prescribing opioids for pain. I am unaware of any effort to engage in agonistic democracy with the pain specialists and creators of the NPS over opioids. Since science has failed to settle issues regarding the use of opioids for pain- the CDC or Obama administration should use advanced dialogical methods to resolve differences between the parties.
    The CDC’s plan is very thin on pain literacy and building the capacity of people in pain to know what treatments are available and decide what is best. The focusing bias on opioids misses the mark-and if people continue to receive poor pain care they are likely to continue to use or abuse alcohol, opioids, heroin, etc

  2. Avatar
    Lisa October 28, 2015 at 1:31 pm - Reply

    What everyone is over looking is that substance abuse of anything, is a MENTAL HEALTH ISSUE….instead we go & blame doctors for writing the scripts. True pain needs treatment. Doctors have to be knowledge & educated enough to know someone who is drug seeking & someone who is in true pain. The biggest obstacle we face today is a true understanding of substance abuse & addiction, also a “stigma” or “label” that is put on people who are using substances.

    • Avatar
      Greg November 1, 2015 at 12:40 pm - Reply

      Doctors for the most part are very good at discerning patients in actual pain as compared to those who are abusing and/diverting drugs. A bug problem today is the tie-in of custom satisfaction scores with reimbursement. I’m an ER Physician and have seen this impact firsthand. Patients coming in for opioid prescriptions for the purpose of abuse or diversion will not settle for less and give horrible scores to the physician and hospital. Statistically, at a glance the number of drug abusers doesn’t seem high enough to effect the scores; however, these patients tend to be frequent repeats, be more likely to submit evaluations, and be more likely to socially bash the hospital to others. ER Physicians, as subcontractors have been fired from jobs for this. Physicians end up giving in to keep their jobs. Pain control in the setting of potential substance abuse of course is a complex problem. This hopefully will shed some light on one aspect of it.

  3. Avatar
    LISA October 28, 2015 at 8:12 pm - Reply

    I see that you left parts of my comment out …above^^^…its ok….I posted on my facebook wall & other nursing & addiction pages on FB with my real comment.
    What we really need to bring to the spotlight, also,
    is the number of Healthcare Professionals (Nurses, Doctors, Anesthesiologists, Pharmacists ) that are in active addiction or in recovery from substance abuse,that would be a true wake up America…this is the real truth of Mental Health , Behavioral Health & substance abuse…..everyone is so hush hush about….how can anything truly be done to make a difference if its hidden…..
    The first thing you learn in Mental Health & Addiction & RECOVERY is “You’re only as sick as your secrets”
    so as long as this stays hush hush…we as a nation will continue this disease …..

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