Drug Monitoring Program Produces Huge Drop in Painkiller Overdose Rate

Posted on July 17th, 2015

New findings from American researchers point to a notable drop in oxycodone-related opioid overdoses in states that set up monitoring programs designed to detect the inappropriate diversion and consumption of prescription opioid medications.

Oxycodone is a powerful opioid substance that serves as the active ingredient in prescription medications that include Percocet, Percodan and OxyContin. Since its introduction on the American market, OxyContin in particular has been a primary target of people who misuse prescription opioids for recreational purposes. Unfortunately, a significant number of oxycodone misusers/abusers will die from an opioid overdose. In a study published in early 2015 in the journal Drug and Alcohol Dependence, researchers from the University of Florida assessed the overdose-related effectiveness of a statewide monitoring program designed to (among other things) deter oxycodone misuse.

Oxycodone and OxyContin

Oxycodone is made in pharmaceutical laboratories from thebaine, a naturally occurring mind-altering substance found in the opium poppy. Like other opioid medications, it produces pain relief by interfering with the brain’s ability to accurately sense or interpret the painful nerve signals relayed from the body. Oxycodone also shares the capacity of all opioids to sharply boost levels of a rewarding sensation known as euphoria, which is generated in a brain area called the pleasure center. Some people misuse oxycodone or other opioid medications out of a desire to increase the pain-relieving benefits of these substances. However, a recreational desire to get “high” drives many instances of prescription opioid misuse. Whatever the underlying motivation, people who inappropriately consume any opioid medication have a very real chance of overdosing or developing a diagnosable condition called opioid use disorder (opioid abuse and/or addiction).

OxyContin is an extended-release form of oxycodone that normally produces its painkilling and euphoric effects gradually over time. However, since its introduction on the U.S. market, this medication has been a fairly constant target of people who seek to overcome its delayed-release feature by crushing it and improperly injecting it, smoking it or consuming it through nasal inhalation. When used in any of these ways, OxyContin delivers its powerful opioid impact rapidly rather than gradually. Rapid onset of the medication’s effects is accompanied by significantly higher risks for opioid addiction and overdose. Revisions of the OxyContin formula have reduced the medication’s susceptibility to crushing and other forms of inappropriate manipulation. Still, substantial numbers of misusers/abusers continue to preferentially target OxyContin.

Opioid Overdose

A person in the midst of an opioid overdose has enough of an opioid drug or medication in circulation to severely suppress activity in the central nervous system (brain and spinal cord). This level of suppression can easily lead to death by disrupting the normally automatic function of the heart or lungs. Figures released in 2014 by the federal Centers for Disease Control and Prevention indicate that opioid medication overdoses claim the lives of roughly 46 Americans every day. This fatality rate far outstrips the rate associated with heroin overdoses.

Can Monitoring Programs Help?

In the study published in Drug and Alcohol Dependence, the University of Florida researchers assessed the impact of state monitoring programs on the rate of opioid overdoses linked to the consumption of oxycodone. Specifically, the researchers explored the effectiveness of Florida’s Prescription Drug Monitoring Program, which was established in 2011. This program keeps track of every prescription written for oxycodone or any other mind-altering medication; it also makes it easy for researchers and public health officials to track trends in prescription writing throughout the state.

Since the creation of the Prescription Drug Monitoring Program, fatal oxycodone-related overdoses have declined substantially throughout Florida. The researchers attribute this decline to a number of influences, including enforcement of laws that prohibit doctors from establishing “pill mills” that thrive on improper prescription writing, the shutdown of pain clinics that essentially function as drug distribution centers and the introduction of crush-resistant OxyContin. However, they also directly attribute fully one-quarter of the drop in oxycodone-related fatalities to the establishment and continued use of the Prescription Drug Monitoring Program.

The study’s authors found that the Florida monitoring program is particularly effective at tracking trends in prescription drug consumption. In fact, the program produces better results than a Kentucky-based effort that once set the benchmark for medication oversight.

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