A Plan For Monitoring Pain Medication

Many addictions to prescription painkillers begin as a legitimate need for relief. An injury may lead to chronic pain, requiring more treatment than what can be achieved through over-the-counter pain pills. Armed with a prescription, a patient begins to feel relief.

However, painkiller use often spirals out of control when the patient requires ever-increasing doses of medication to achieve the same results. A need for more medication may lead to visiting multiple doctors to receive painkiller prescriptions, or otherwise unsafe behaviors.

Approximately three-quarters of all fatal drug overdoses taking place in the United States are the result of the abuse of prescription drugs. These deaths outnumber those due to heroin and cocaine and are even beginning to rival car accidents as the number one cause of preventable death.

An article published in the New England Journal of Medicine provides a plan for a new program that would monitor the path of prescription drugs. It would allow doctors, pharmacists, dentists, law enforcement personnel and researchers to examine real-time information on patients’ use of prescription drugs.

Authored by Jeanmarie Perrone, MD, an associate professor of Emergency Medicine at the University of Pennsylvania Perelman School of Medicine, and Lewis S. Nelson, MD, a professor of Emergency Medicine at New York University School of Medicine, the plan provides guidelines for a much safer set of practices regarding prescription painkillers.

The program is designed to allow physicians the freedom to provide excellent care for patients who require pain medication, as well as detecting patients who may have a drug problem. Overall, the program would greatly reduce the number of opioid prescriptions in circulation, which often end up in an illegal sale.

Authors of the study liken their plan to the safety features developed by the automobile industry to prevent deaths. Despite increased use of automobiles over the last few decades, safety innovations have made it safer to drive, and the authors hope that their plan will offer the same types of benefits.

Building on state-run monitoring programs from as early as 1993, the plan would capitalize on the improvements made in Internet use, electronic medical record systems and e-prescribing systems.

In total, 42 states currently have programs developed to monitor prescription drugs, and an additional six states have legislation enacted, ready to implement them. In addition, support from the Centers for Disease Control and Prevention and the Food and Drug Administration will help increase efforts.

In some cases however, physician awareness requires improvement and in some states physicians are even restricted from accessing the records they need to determine safe prescription use. In those states the databases are limited to use by law enforcement officials.

Nelson and Perrone call for a standardization of the information logged by the databases, and a general move towards bar-coding on prescription paper so as to efficiently record entries. Another option would be to eliminate the paper and connected fraud to eliminate patients from visiting multiple doctors to receive duplicate prescriptions.