Nearly15,000 people die each year from overdose of prescription medications (CDC Vital signs 2011). Deaths attributed to prescription drug overdoses are America’s fastest growing drug-related problem and outnumber deaths from both heroin and cocaine, combined. The problem has no boundaries. Each day, it seems, we hear about another celebrity death from prescription medications. We may even have family and/or friends who have been personally affected by the abuse of prescription medications, especially opioids.
One sobering statistic is that the United States of America represents only 4% of the total world’s population; however, the U.S. consumes close to 80% of the world’s opioid supply. To put that into perspective, the CDC report states that “Enough prescription pain killers were prescribed in 2010 to medicate every American adult around the clock for a month.” Hydrocodone/APAP is routinely in the top five of medications dispensed yearly by pharmacies, accounting for 132 million prescriptions annually. The workers’ compensation arena is not immune to this epidemic, as the use of opioid medications is at an all-time high in the industry.
There have been many blog postings and articles on effective ways to reduce opioid use in workers’ compensation cases advocating education, along with prescription drug monitoring and control. This is a good first step. We have seen REMS introduced as a way to educate physicians, patients, and other healthcare providers on the risks and benefits with these types of medications. Many states have now adopted prescription drug monitoring programs to electronically track prescriptions with the goal to decrease “Doctor shopping” and filling at multiple pharmacies. Recently, the DEA suspended the licenses of a major wholesaler and pharmacy chain due to the excessive quantities of opioids dispensed. As a practicing pharmacist, I applaud states that decide to develop comprehensive prescription drug monitoring programs (PDMPs). This is long-overdue and should prove beneficial moving forward.
Last year the White House released a paper entitled, “Epidemic: Responding to America’s Prescription Drug Abuse Crisis.” The report cited more statistics quantifying the problem and offered four main areas that could help to solve it: Education, Tracking and Monitoring, Proper Disposal of Medications, and Enforcement. I recommend that you read the report.
Healthcare professionals must be held accountable during this crisis, as well. Physicians have a responsibility to properly prescribe medications and pharmacists have the duty to properly fill those prescriptions, while ensuring that a patient’s health is not compromised and the physician order is appropriate.
The inaugural National Rx Drug Abuse Summit will be held in Orlando, Florida next month. The purpose of this summit is to bring together experts in the healthcare field to discuss this problem and effective ways to solve it. My next blog posting will report on this conference and the results of it.
There is a long ways to go in workers’ compensation with the prescription drug issue. Recognition of this problem is a good first step to achieving long-term goals and solutions. It is my hope that both awareness and education are instrumental in curbing inappropriate opioid usage which can lead to preventable death.
About the Author: William F. Bell, Jr. is the Senior Clinical Pharmacy Specialist for Gould & Lamb, LLC. His primary responsibility is the review of a claimant’s pharmacotherapy regimen and the identification of off-label medications in a Medicare Set Aside Allocation. He has given numerous presentations on the subject of medication management and how it relates to Workers’ Compensation and Medicare Set Aside Claims. Bill has also authored two continuing education articles for the Pharmacist’s Letter, a nationally known education resource for practicing pharmacists.