In fight against prescription drug abuse, docs need more information

By Peter W. Carmel, M.D., president, American Medical Association

Prescription drug abuse is an epidemic that cannot be ignored. According to the Centers for Disease Control and Prevention, prescription drugs are now involved in more overdose deaths than heroin and cocaine combined. Physicians are serious about combating this epidemic, but we can’t do it alone.

The National All Schedules Prescription Electronic Reporting (NASPER) bill was signed into law in 2005 to give physicians an effective tool to help address drug diversion. This legislation was designed to create prescription drug monitoring programs (PDMPs) in each state so physicians could access important information to help them appropriately treat their patients’ pain or illness while helping to prevent the abuse and diversion of controlled substances. Unfortunately, the program was never fully funded and never realized its full potential.

When properly constructed and operated, PDMPs have proven extremely effective in fighting diversion while ensuring that individuals in need of treatment for pain and suffering receive care. Due to inadequate funding, the majority of PDMPs today do not operate in real-time, are not interoperable between states and are not available to physicians at the point of care. Absent this information, patients who are intent on diverting controlled substances or “doctor shoppers” are difficult to identify.

The AMA urges passage of NASPER 2011 legislation to establish and modernize existing PDMPs so that states can ensure interstate interoperability and real time access for prescribers at the point of care. We also support efforts to harness health information technology capabilities that could make PMDP data available to physicians as part of the normal work flow of their office and emergency departments.

While access to patient prescribing information at the point of care is important, continuing medical education (CME) will also help the appropriate physicians combat prescription drug abuse, provide information about trends in abuse and help physicians work with patients on proper storage of controlled substances. The AMA offers an online CME focused on pain management and is also preparing a series of webinars on responsible opioid prescribing as part of a prescriber clinical support system led by the American Academy of Addiction Psychiatry.

We believe strongly that profession-developed educational efforts like these, rather than government mandated training programs as suggested by some, can help address this problem meaningfully while reinforcing the patient-physician relationship.

Finally, the public needs to know how and where to properly and safely dispose of controlled substances. Prescription drugs in the home are highly susceptible to diversion, misuse and abuse, and improper drug disposal can also pose a threat to the environment.

The DEA hosts periodic events to safely retrieve unused prescription drugs, and the next National Prescription Drug Take-Back Day is April 28, but there is no place for people to return unused drugs safely and legally all year. The AMA supports legislation that would address this issue, as this is an important part of the overall strategy for combating diversion.

The AMA is deeply involved and committed to efforts that will curb prescription drug abuse and diversion. We will continue to work with physicians, Congress and the public in order to find solutions that will truly help stem an epidemic that has already claimed too many lives.

Carmel, M.D., is the president of the American Medical Association. He is a pediatric neurosurgeon who practices in Newark, NJ.
Source: The Hill