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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 | , , | Leave a comment

2013 World Drug Report: stability in use of traditional drugs, alarming rise in new psychoactive substances

From the summary at Full Text Reports

 

2013 World Drug Report: stability in use of traditional drugs, alarming rise in new psychoactive substances
Source: United Nations Office on Drugs and Crime

The 2013 World Drug Report released today in Vienna shows that, while the use of traditional drugs such as heroin and cocaine seems to be declining in some parts of the world, prescription drug abuse and new psychoactive substance [NPS]

An arrangement of psychoactive drugs

An arrangement of psychoactive drugs (Photo credit: Wikipedia)

abuse is growing. In a special high-level event of the Commission on Narcotic Drugs, UNODC Executive Director Yury Fedotov urged concerted action to prevent the manufacture, trafficking and abuse of these substances.

Marketed as ‘legal highs’ and ‘designer drugs’, NPS are proliferating at an unprecedented rate and posing unforeseen public health challenges. The report shows that the number of NPS reported to UNODC rose from 166 at the end of 2009 to 251 by mid-2012, an increase of more than 50 per cent. For the first time, the number of NPS exceeded the total number of substances under international control (234). Since new harmful substances have been emerging with unfailing regularity on the drug scene, the international drug control system is now challenged by the speed and creativity of the NPS phenomenon.

This is an alarming drug problem – but the drugs are legal. Sold openly, including via the internet, NPS, which have not been tested for safety, can be far more dangerous than traditional drugs. Street names, such as “spice”, “meow-meow” and “bath salts” mislead young people into believing that they are indulging in low-risk fun. Given the almost infinite scope to alter the chemical structure of NPS, new formulations are outpacing efforts to impose international control. While law enforcement lags behind, criminals have been quick to tap into this lucrative market. The adverse effects and addictive potential of most of these uncontrolled substances are at best poorly understood.

The global picture for the use of traditional drugs such as heroin and cocaine shows some stability. In Europe, heroin use seems to be declining. Meanwhile, the cocaine market seems to be expanding in South America and in the emerging economies in Asia. Use of opiates (heroin and opium), on the other hand, remains stable (around 16 million people, or 0.4 per cent of the population aged 15-64), although a high prevalence of opiate use has been reported from South-West and Central Asia, Eastern and South-Eastern Europe and North America.

 

 

 

 

July 19, 2013 Posted by | Consumer Health, Consumer Safety, statistics | , , , , , , , , , | 1 Comment

Drug Abuse Warning Network, 2011: National Estimates of Drug – Related Emergency Department Visits

drugs redux

drugs redux (Photo credit: Phoenix Dark-Knight)

 

Summary of the paper from Full Text Reports

 

Drug Abuse Warning Network, 2011: National Estimates of Drug – Related Emergency Department Visits (PDF)
Source: Substance Abuse and Mental Health Services Administration

This publication presents national estimates of drug – related visits to hospital emergency departments (EDs) for the calendar year 2011 , based on data from the Drug Abuse Warning Network (DAWN). Also presented are comparisons of 20 11 estimates with those for 2004, 200 9, and 2010 . DAWN is a public health surveillance system that monitors drug – related ED visits for the Nation and for selected metropolitan areas. The Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS), is the agency responsible for DAWN. SAMHSA is required to collect data on drug – related ED visits under S ection 505 of the Public Health Service Act.

DAWN relies on a nationally representative sample of general, non – Federal hospitals operating 24 – hour EDs , with oversampling of hospitals in selected metropolitan areas. In each participating hospital, ED medical records are reviewed retrospectively to find the ED visits that involved recent drug use. All types of drugs — illegal drugs, prescription drugs, over – the – counter pharmaceuticals (e.g., dietary supplements, cough medicine), and substances inhaled for their psychoact ive effects — are included. Alcohol is considered an illicit drug when consumed by patients aged 20 or younger. For patients aged 21 or older, though, alcohol is reported only when it is used in conjunction with other drugs.

Marked findings of this report a re (a) a 29 percent increase in the number of drug – related ED visits involving illicit drugs in the short term between 2009 and 2011 ; (b) simultaneous, short – term increases in the involvement of b oth illicit and licit stimulant – like drugs ; and (c) some ind ications that the pace of increases in pharmaceutical involvement is slowing down.

 

 

July 19, 2013 Posted by | health care | , , , , , , , , | Leave a comment

As Painkiller Overdoses Mount, Researchers Outline Effective Approaches to Curb Epidemic

 

English: A graphic map showing the rates of ac...

English: A graphic map showing the rates of accidental prescription drug overdose deaths for the state of Ohio by counties for the years 2004 to 2008. Information obtained from here and here. (Photo credit: Wikipedia)

 

From the 19 September 2012 article at Science News Daily

 

“Good things happen when state prescription drug monitoring programs shift to a proactive strategy,” said Dr. Nathaniel Katz, assistant professor of anesthesia at Tufts University School of Medicine. “Not only can it prevent painkillers from being misused or distributed illegally in the first place, but it can also enable health professionals to identify patients who need help overcoming addiction.”

 

September 21, 2012 Posted by | Consumer Health | , , , | Leave a comment

   

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