The number of people using prescription opioids recreationally has increased substantially since the 1990s, say researchers. In addition, the number of people who become addicted to these drugs or die from overdoses has also increased.

Currently, in the United States, nearly 75% of all fatal drug overdoses are due to prescription drugs. This figure significantly outnumbers the mortality rate from cocaine and heroin combined.

In the New England Journal of Medicine, medical toxicologists Jeanmarie Perrone, M.D., an associate professor of Emergency Medicine in the Perelman School of Medicine at the University of Pennsylvania, and Lewis S. Nelson, M.D., a professor of Emergency Medicine at the New York University School of Medicine, outline a plan for an “ideal” prescription-drug monitoring program that would allow, medical professionals, researchers, law enforcement officials, pharmacists, and dentists to access real-time data on patients’ prescription drug histories.

According to the researchers, these types of programs would allow medical professionals to take better care of individuals who are suffering from legitimate pain issues. In addition, such programs would also help to identify and intervene to help potential drug abusers, and reduce the amount of pain medications in circulation for illegal sale.

The researchers said:

“As the number of deaths associated with prescription-drug use surpasses the number of fatalities from motor-vehicle crashes in many states, we can learn from the success of auto-safety innovations that have mitigated mortality despite increased automobile use over the past three decades.

We should initiate active safety measures to address the growing rates of illness and death associated with the pharmaceuticalization of the 21st century.”

At present, 42 states have state-run prescription-drug monitoring programs, and 6 have enacted legislation to develop the programs. In addition, federal agencies, including the Food and Drug Administration, and the Centers for Disease Control and Prevention have called for increased efforts. However, in some states, databases can only be accessed by law enforcement officials and not physicians.

Furthermore, attention about potential abuse of painkillers, such as oxycodone and hydrocodone, has been increasing and has damaged the relationship between physicians and their patients who have legitimate chronic pain issues.

For example, some recommendations suggest that physicians should get patients to sign a “pain contract” in which they must agree to not sell of give their medications to other people.

Perrone and Nelson state that a drug-monitoring system designed to better inform physician prescribing, will help avoid unintended consequences as well as help physicians to better identify and help those who abuse prescription medications.

Some of their recommendations include:

  • bar-coded prescription paper to record entires faster
  • standardization of the type of information submitted to the databases
  • an e-prescribing system that would eliminate paper, thus eliminating prescription fraud
  • In addition, they recommend that the programs track which drugs have the most potential for abuse or addiction.

    According to Perrone and Nelson, these programs would help identify individuals who receive multiple legitimate prescriptions from different physicians and pharmacies; give clinicians and early warning signal that a patient may require drug counseling or treatment; and give clinicians the chance to intervene while the patient is still in the medical setting.

    Furthermore, the prescribers could use the programs to monitor use of their own Drug Enforcement Administration number to identify fake or stolen prescriptions.

    Perrone explained: “Although updating an existing prescription-drug monitoring database to incorporate these ‘ideal’ goals would require additional support and money, the potential to protect the public health is substantial.”

    Written By Grace Rattue