Prescription Monitoring Programs Failing Public on Overdose Prevention
In the 21st century, America has been gripped by a well-publicized increase in prescription drug prescribing and an associated rise in the number of prescription overdoses and overdose-related fatalities. As a consequence, overdose prevention is strongly emphasized by the Centers for Disease Control and Prevention (CDC) and other public health agencies. In a study published in May 2015 in the journal Drug and Alcohol Dependence, a team of American researchers examined the efforts that state-level prescription drug monitoring programs have made to promote overdose prevention through their websites.
Much of the focus on prescription overdose centers on opioid medications, which are misused far more often than any other type of prescription drug in the U.S. Opioid drugs and medications produce much of their effect by substantially reducing the speed of communication between the main nerve cells or neurons located in the brain and the spinal cord (which together form the central nervous system). The central nervous system must sustain a baseline level of neuron activity in order to keep you alive, and anything that lowers activity below a minimum safe threshold can kill you. Opioid overdoses occur when a consumer of opioid drugs or medications takes too much of the substance in question and reduces his or her central nervous system activity below the minimum threshold. Without proper signaling from active neurons, heart function, lung function and other critical organ functions will start to shut down, and a person experiencing an opioid overdose can easily die with or without prompt medical attention.
In the late 1990s and throughout the 2000s, doctors in the U.S. wrote a steadily increasing number of opioid prescriptions for their patients. Among other things, this widespread uptick in prescribing led to ample opportunities to improperly obtain opioid medications and/or consume those medications for unsanctioned purposes. In turn, large-scale misuse of prescription opioids led to a nationwide rise in overdoses and overdose-related deaths. Opioid prescribing reached its peak in 2011-2012, and the number of opioid medication-associated overdoses has begun to fall. Still, the CDC reports that more than 40 Americans continue to die from prescription opioid overdoses each day of the year.
Prescription Drug Monitoring Programs
Prescription drug monitoring programs are primarily intended to provide state-level oversight on current patterns in prescription medication prescribing and distribution. By tracking these patterns, program administrators can identify likely cases of inappropriate medication diversion and help doctors and pharmacists determine if their patients/customers have had issues with prescription drug diversion in the past. Since prescription drug monitoring programs are computer-based and typically feature websites with some degree of public access, they can potentially act as an authoritative source on overdose risks, overdose trends and methods of overdose prevention.
Emphasis on Overdose Prevention
In the study published in Drug and Alcohol Dependence, researchers from Inflexxion Inc., the Network for Public Health Law and a private practice conducted a review of the websites maintained by 47 statewide prescription drug monitoring programs. The purpose of this review (conducted between the end of 2012 and the fall of 2013) was to determine how often these websites feature content geared toward overdose education or prevention. Aspects of education and prevention considered by the researchers included the reduction of prescription opioid intake in legitimate medical settings, methods to reduce the supply and demand for opioid medications and methods to reduce the incidence of overdose and other forms of opioid-related harm.
After completing their review, the researchers found that almost two-thirds of monitoring program websites under consideration did not mention overdoses at all or any of the search terms commonly associated with overdoses. Just six of the 47 websites had content clearly intended to deal with overdose-related issues, and just two of the websites provided doctors and other database users with detailed information about overdose prevention.
The study’s authors note that prescription monitoring program websites that dealt in detail with overdose-related issues could significantly increase their usefulness as public health resources in the effort to reduce the number of overdoses and overdose fatalities. Such a perspective supports an integrated approach to addressing overdose-related issues across the U.S.