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General interest items edited by Janice Flahiff

[Journal article] Prescription Drug Abuse: A Policy Position Paper From the American College of Physicians

From the 10 December 2013 Annals of Internal Medicine article

Prescription drug abuse is found throughout all aspects of the U.S. population and is a serious public health problem. Physicians and other health professionals with prescribing privileges are entrusted with the authority to use medications in the treatment of their patients and therefore have an important role in helping to ensure safe and effective use of this treatment option and the deterrence of its abuse. This paper is intended to provide guidance to prescribers and policymakers regarding measures to effectively address the problem of prescription drug abuse and offers the following recommendations:

1. ACP supports appropriate and effective efforts to reduce all substance abuse. These include educational, prevention, diagnostic, and treatment efforts. As physicians dealing with the health effects of this condition, we also support medical research on addiction and its causes and treatment.

2. ACP supports a comprehensive national policy on prescription drug abuse containing education, monitoring, proper disposal, and enforcement elements.

3. ACP supports the consideration by physicians of the full array of treatments available for the effective treatment and management of pain.

4. ACP supports the establishment of a national Prescription Drug Monitoring Program (PDMP). Until such a program is implemented, ACP supports efforts to standardize state PDMPs through the federal National All Schedules Prescription Electronic Reporting (NASPER) program. Prescribers and dispensers should check PDMPs in their own and neighboring states (as permitted) prior to writing or filling prescriptions for medications containing controlled substances. All PDMPs should maintain strong protections to assure confidentiality and privacy.

5. ACP supports efforts to educate physicians, patients, and the public on the appropriate medical uses of controlled drugs and the dangers of both medical and nonmedical use of prescription drugs.

6. ACP favors a balanced approach to permit safe and effective medical treatment utilizing controlled substances and efforts to reduce prescription drug abuse. However, educational, documentation, and treatment requirements toward this goal should not impose excessive administrative burdens on prescribers or dispensers.

7. ACP recognizes that defined maximum dosage (i.e., morphine equivalent) and duration of therapy limitations are not applicable to every clinical encounter. ACP favors establishment of evidence-based, nonbinding guidelines regarding recommended maximum dosage and duration of therapy that a patient taking controlled substance medications may receive.

8. Patients identified by Medicare, Medicaid, private insurance plans, or law enforcement authorities as being at significant risk of prescription drug abuse may be required to participate in a drug monitoring program and undergo random drug testing. Physicians may be required to report suspected cases of drug abuse, but should not be mandated to conduct random drug testing without the patient’s consent. The financial cost of mandatory drug testing should be borne by the authority requiring the testing; neither the patient nor the physician should bear the financial cost of random drug testing mandated by a third-party authority.

9. ACP recommends the consideration of patient-provider treatment agreements between physician and patients as a tool for the treatment of pain.

10. ACP recommends the passage of legislation by all 50 states permitting electronic prescription for controlled substances.


Read the entire article here



December 11, 2013 - Posted by | health care | , ,

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