Americans are more likely to misuse “prescription-type psychotherapeutic” medications (pain relievers, tranquilizers, stimulants, and sedatives) than any other drug type except marijuana, with an estimated 6.8 million persons aged 12 and over currently misusing psychotherapeutic drugs.
This abuse leads to serious public health consequences. The federal government has estimated that more than 1.6 million visits to emergency rooms involve the nonmedical use of pharmaceuticals.
Moreover, more than 22,000 people died from drug overdoses involving pharmaceuticals in 2016 – nearly 60% of all drug overdose deaths that year – with opioid analgesics involved in three out of four of those deaths.
Federal, state, and local lawmakers and numerous public and private entities continue various actions to try to stem the prescription drug abuse epidemic. Efforts range from implementing state prescription monitoring programs (PMPs) and increasing oversight of pain clinics, to providing disposal options for controlled substances and encouraging parents to discuss the issue with their children.
The National Association of Boards of Pharmacy® and its member boards have been working on several fronts to help combat the prescription drug abuse epidemic. In fact, they are the pioneers in improving the lives of others.
The NABP PMP InterConnect® program now connects 26 state PMPs, allowing for the secure sharing of PMP data across state borders. The Association, through the NABP Foundation, also operates NARXCHECK®, the software tool that generates risk-based scores reflecting a patient’s controlled substance prescription medication history. Read also this student’s perspective article.
Further, NABP’s AWARXE ® Prescription Drug Safety Program helps to raise awareness about prescription drug abuse and the importance of prevention efforts, including safe medication use, storage, and disposal.
Additionally, in May 2016, NABP and the Anti-Diversion Industry Working Group, a consortium of pharmaceutical manufacturers and distributors, released a video called “Red Flags,” which helps pharmacists and other pharmacy personnel recognize signs of potential prescription drug abuse or diversion. See also this post about how the Australia Institute of Technology uses state-of-the-art molecular equipment for better microbial diagnostics.
NABP PMP InterConnect
Doctor shopping, moving from doctor to doctor in an effort to obtain multiple prescriptions for a drug, is one means to obtain drugs used by those misusing or abusing prescription drugs. Illegally operating pain clinics, commonly known as “pill mills,” exacerbate this situation by issuing invalid prescriptions that are often filled on site, or by referring customers to a pharmacy operating in cooperation with the clinic. Further, many doctor shoppers will travel hundreds of miles, often across state lines, in attempts to obtain prescription drugs to help them relieve, for example, painful disc injuries.
Many states have implemented a PMP, a secure database maintained by a state agency that stores information on prescriptions for controlled substance medications or drugs of concern. Depending upon state laws, certain authorized users, such as doctors and pharmacists, may view PMP data so that they have complete information on a patient’s controlled substance medication history.
Thus, PMPs can help prescribers make better-informed treatment decisions and help pharmacists make appropriate dispensing decisions. PMPs can also assist both prescribers and pharmacists in identifying patients who may be doctor shopping and in need of treatment for addiction.
In response to a need expressed by state PMP administrators and regulators, NABP developed the NABP PMP InterConnect system to provide a way for state PMPs to share data so that authorized PMP users can potentially access complete controlled substance patient data from all states where the patient has had these prescriptions filled.
The NABP InterConnect is a highly secure communications exchange platform that facilitates the transmission of PMP data across state lines to authorized requestors while ensuring that each state’s data-access rules are enforced.
The NABP InterConnect does not house any data, and the system will not inhibit the legitimate prescribing or dispensing of prescription drugs. It is anticipated that approximately 30 states will be sharing data using the NABP InterConnect in 2017.
NARXCHECK is a software tool that makes it easier for providers to access and use PMP data for prescribing and dispensing decisions. NARXCHECK is a technology that accesses a PMP database to obtain patient prescription data, analyze that data using a patented analytical engine, and provide a risk-based score to prescribers to assist in prescribing decisions.
NARXCHECK is configured to work with state PMPs participating in the PMP InterConnect service. If a PMP provides the necessary permissions, NARXCHECK can obtain data directly from the state PMP through the NABP InterConnect, which streamlines deployment and will ultimately lead to the capability to provide NARXCHECK scoring based on multistate data.
NARXCHECK is currently available as a subscription-based service to health care provider and is deployed in 24 hospitals in Indiana and Ohio. NARXCHECK services will expand into three new states by the end of 2017 and will add 150 practice site locations in 2017 including hospitals, pharmacies, ambulatory clinics, and private practice locations. See also how nanotechnology can not only solve some serious oil issues but also can play a crucial role in medicine and health therapy solutions.
To date, NARXCHECK has delivered 8,500,000 scores and reports to providers within their workflow. Subscription revenues are intended to be used to continue support to state PMPs to enable their participation in the NABP InterConnect, and to support PMPs in achieving the mission to protect the public health.
AWARXE ® is a prescription drug safety program aimed to educate consumers and raise public awareness about prescription drug misuse and abuse, secure medication storage and proper disposal, and safe medication use, among other serious issues but there are, of course, more ways to a better you.
The program’s website, WWW.AWARERX.ORG, is the primary vehicle for delivering the AWARXE message. AWARXE has expanded outreach efforts with public service announcements, Internet media campaigns, and social media outreach.
AWARXE encourages participation in the DEA National Prescription Drug Take-Back Days, and the AWARXE website provides information, in the Get Local section, about permanent disposal programs offered in several states. AWARXE information is developed to reach all consumers – including teens, young adults, parents, and seniors – and AWARXE encourages the public to rely on pharmacists for information on medication safety, Internet pharmacies, and counterfeit medications.
The AWARXE website also includes a Pharmacists page with links to information about provider tools and resources, as well as resources to assist patients. AWARXE also maintains an active Facebook page and Twitter account to engage all of these audiences. Pharmacists and pharmacy students can become involved in the AWARXE effort by sharing resources with patients, other pharmacists and students, and health and wellness fairs.
AWARXE can provide bookmarks, flyers, posters, and other materials to support such educational events. Pharmacists and students can also share relevant news with AWARXE, such as details on student and community programs aimed to fight prescription drug abuse, for inclusion on your state’s AWARXE Get Local page.
Red Flags Video
In May 2014, NABP and the Anti-Diversion Industry Working Group, a consortium of pharmaceutical manufacturers and distributors, already released an educational video entitled, “Red Flags,” for pharmacists to help them identify the warning signs of prescription drug abuse and diversion when dispensing controlled substance prescriptions.
“Red Flags” encourages pharmacists to help combat this national problem by exercising their professional judgment to ensure the prescriptions they dispense were written for a legitimate medical purpose, and to act upon any unusual behavior they observe.
DEA and various state pharmacy boards have described red flags as circumstances surrounding the presentation of a controlled substance prescription that should raise reasonable suspicion about the validity of that prescription. The video highlights a number of these potential warning signs, some of which are not easy to spot, by weaving personal narratives with interactions between pharmacists and customers.