Prescription drug abuse has ballooned out of control over the past decade. Drug overdose is now the leading cause of accidental death in the United States. The main culprit behind the overdose deaths is prescription painkillers. Since 1999, the amount of prescription painkillers prescribed and sold in the United States has nearly quadrupled, yet there has not been an overall change in the amount of pain that Americans report. Over-prescribing leads to more abuse and more overdose deaths.
To prevent over-prescribing and "doctor shopping" 49 out of the 50 states in the United States have implemented a Prescription Drug Monitoring Program or "PDMP." Doctor shopping is when a patient will go to multiple doctors trying to obtain as many opiate prescriptions as they can. When the PDMP's were first established, it allowed doctors and pharmacists the ability to see how many prescriptions a patient was on and how many doctors they were seeing. It had a profound impact on the amount of prescription opiates that were on the black market.
Now the information from the prescription drug monitoring systems is being shared between multiple states to detect trends in prescribing and abuse of controlled substances according to a report released today by the Centers for Disease Control and Prevention's (CDC) Morbidity and Mortality Weekly Report (MMWR) Surveillance Summary.
This is the first multi-state report of its kind and the CDC is in charge while the FDA funds the Prescription Behavior Surveillance System (PBSS) which compares and analyzes all of the data on the state prescription drug monitoring systems. The analysis is not from all 49 monitoring programs. The states that submitted their 2013 data were West Virginia, Idaho, Maine, Louisiana, Ohio, Florida and California which is about a quarter of the U.S. population.
The study found that although prescribing practices varied widely in each of the states, the urgency for improved prescribing practices of opioid medications was extremely obvious across the board. Opioid medications were prescribed twice as often as stimulants (Ritalin, Adderall) and benzodiazepines (Xanax).
"Every day, 44 people die in American communities from an overdose of prescription opioids and many more become addicted," said CDC director Tom Frieden, M.D., M.P.H. "States are on the front line of witnessing these overdose deaths. This research can help inform their prescription overdose prevention efforts and save lives."
The obvious findings from the research was that over-prescribing is still very much an issue. Prescribing rates did vary widely by state, twofold for opioid medications, fourfold for stimulants and nearly twofold for benzodiazepines. The majority of over-prescribing of opiate medications come from a very small minority of physicians. To show the differences in prescribing practices, the top one percent of prescribers wrote one in four opiate prescriptions in Delaware compared to one in eight in Maine. Patients who received opioid medications often receive benzodiazepine prescription as well which is quite terrifying considering the adverse effects between the two medications. When a person overdoses from an opioid medication, it is very common for the person to have benzodiazepines such as Xanax or Valium in their system as well.
The data that was collected during this study by the CDC will provide incredible information and trends for physicians to study. It will allow the government to gain more data that can be used to set standards for prescribing and will open the doors to more states sharing their data. The more information that is compared, the better we can study prescribing trends and hopefully find ways to reduce opiate and other narcotic related deaths.