'A lot to do' to change painkiller prescribing, researcher says

The launch of drug-monitoring programs in 24 states led toan immediate 30 per cent drop in prescriptions for Schedule IIopioids, the most addictive, in patients with pain complaints,the study showed.

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Bao, a health economist at Weill Cornell Medical College inNew York, and colleagues analyzed 26,275 office visits for painin 24 states that implemented prescription drug-monitoringprograms from 2001 to 2010.

Given how many people are killed by prescription opioidsand how dangerous these drugs are, it should be no lessimportant for a clinician to check a prescriptiondrug-monitoring program before prescribing an opioid than tocheck kidney function before prescribing a new blood-pressuremedicine.-Dr. Caleb Alexander

The study confirmed Bao's hypothesis that physiciandrug-monitoring programs, which have been implemented in a widevariety of forms in every state except Missouri, are aneffective tool to combat the opioid drug epidemic. But shestressed the need for other means as well.

"The interventions are needed along the continuum here from manufacturers to end-users. This is important to keep inmind given the magnitude of addiction, injuries and deaths,"said Alexander, who was not involved in the current study.

Overdose deaths, along with sales of prescription opioids,have quadrupled since 1999, the CDC estimates. More than 165,000Americans died from overdoses related to prescription opioidsfrom 1999 to 2014.

Noopioidis entirely safe

A database could show when patients are obtaining opioidsunder their own name from multiple doctors, which might assistin identifying potential abuse and dependency, he noted.

Drug-monitoring databases may make doctors think twicebefore prescribing pain medications for a variety of reasons inaddition to uncovering "doctor shopping" by patients, the studyauthors write.

Knowing that they're being watched may serve as adeterrent, and the programs may generally increase awareness ofthe dangers of prescribing opioids, they say.

In March, the CDC released guidelines instructing primarycare doctors to sharply curtail use of opioids for chronic pain.

At the time, CDC Director Dr. Tom Frieden called theprescription overdose epidemic "doctor-driven."

Authors of the current study say American clinicians arewriting enough prescriptions to medicate every U.S. adult for amonth.