In a new policy paper being published in Annals of Internal Medicine, the American College of Physicians (ACP) recommends clinical and administrative changes that will make it harder for prescription drugs, such as those prescribed for pain, sleep disorders, and weight loss, to be abused or diverted for sale on the street. ACP's Health and Public Policy Committee developed the position paper to provide guidance to prescribers and policymakers faced with the challenge of deterring prescription drug abuse while maintaining patient access to appropriate treatment.

A recent analysis of preliminary data from the Centers for Disease Control and Prevention (CDC) suggests that prescription drug abuse may now be the leading cause of accidental death in the United States. A 2010 survey funded by the National Institute on Drug Abuse (NIDA) found that 16 million Americans age 12 and older had taken a prescription pain reliever, tranquilizer, stimulant, or sedative for nonmedical purposes at least once in the previous year.

Among the 10 recommendations outlined in the policy paper, ACP strongly advocates for physician, patient, and public education on the harms of medical and nonmedical use of prescription drugs. For the treatment of pain, ACP recommends that physicians consider the full array of treatments available before prescribing opioids. While maximum dosage and duration of therapy limitations may not be appropriate for all patients, ACP recommends the establishment of evidence-based, nonbinding guidelines to inform treatment.

ACP also supports the establishment of a national Prescription Drug Monitoring Program (PDMP) so that prescribers and dispensers may check PDMPs in their own and neighboring states before writing and filling prescriptions for substances with high abuse potential.

A comprehensive summary of the policy paper, including all 10 recommendations, can be found here.