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As prescription drug abuse reaches epidemic proportions, a recent study reports disturbingly low monitoring rates for patients taking powerful prescription drugs. Only 8 percent of patients taking opioid pain medications are screened by their doctor. Fewer than half (49.8 percent) see their prescribing physician regularly. The study of practices in primary care settings was conducted by researchers at Yeshiva University in New York City and was published in the Journal of General Internal Medicine.

The revelation comes as the abuse of prescription medications surpasses the abuse of cocaine, heroin, and methamphetamines, and has been officially labeled an “epidemic” by the federal Centers for Disease Control and Prevention. More than 7 million Americans admit to having recently abused a prescription medication, according to the 2009 National Survey on Drug Use and Health.

Addressing the abuse of prescription medications, and especially pain relievers, is complicated by the need to keep such medications available for lawful use by prescribers and patients. About 70 million Americans currently live with chronic pain, and many are undertreated.

The not-for-profit Center for Lawful Access and Abuse Deterrence (CLAAD), a national alliance of families, medical professionals, law enforcement, and drug abuse prevention advocates, is calling on health care professionals to do more to protect their patients and prevent prescription drug abuse.

“Prescribers can provide higher quality care to their patients and simultaneously protect the public by taking steps to identify potential patterns of prescription drug misuse or abuse,” said Michael Barnes, a spokesperson for CLAAD.

Patients may not always take pain medicine as prescribed. For example, some individuals may choose to take too little due to cost, side effects, or fear of addiction. Others may take too much because the prescribed dosage provides inadequate relief. To help reduce this potential for misuse, as well as the risk of intentional abuse, CLAAD is urging prescribers to incorporate the assessment of patient risk and therapeutic monitoring as “universal precautions” in pain management.

Looking at preexisting problems, such as mental illness or substance abuse history, enables prescribers to design an appropriate therapy and monitor accordingly. Patient monitoring includes the following best practices:

  • Checking the state’s prescription monitoring database to make sure the patient does not already have access to similar medications;
  • Using treatment agreements setting forth the mutual expectations and obligations of the patient and prescriber; and,
  • Utilizing advanced drug testing technologies to identify levels of specific drugs in a patient’s system.

CLAAD set forth the recommendations as early as 2009 in its National Prescription Drug Abuse Prevention Strategy, a policy paper endorsed by 25 not-for-profit health and safety organizations and professional associations. The 2009 and 2010 National Prescription Drug Abuse Prevention Strategy documents may be found online at www.claad.org.


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