Prescription Monitoring Programs Expanding

New York will soon require physicians to refer to an electronic database to see if other physicians have prescribed the same controlled substance to a patient. The goal is to reduce the increasing numbers of fatal overdoses of prescription drugs, which now exceed deaths from heroin and cocaine, said New York Gov. Andrew Cuomo, in a statement. Such state-based prescription-monitoring programs have existed—using paper or fax documentation—since 1993 and  operate in 42 states, with another six in development.

Such programs should cover medications listed on the Drug Enforcement Administration’s schedules 2, 3, 4, and 5, wrote Jeanmarie Perrone, M.D., of the University of Pennsylvania, and Lewis Nelson, M.D., of New York University, in an article published online in the New England Journal of Medicine May 30. The ideal monitoring program, they said, should include ease of access, standardized content, real-time updates, mandatory pharmacy reporting, interstate accessibility, confidentiality and security guarantees, and strictly monitored access for nonprescribers.

To read more about the complexities involved in prescribing pain medications, see Psychiatric News here.

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Drug Companies Ready Purer Form of Highly Abused Opioid

Hydrocodone is currently the second-most-abused medication in the United States, according to a December 26 Associated Press report, and efforts underway by four pharmaceutical firms to introduce a stronger formulation of the drug could increase its potential for misuse. While the drug companies maintain that uncut hydrocodone will limit the dangers associated with such commonly used painkiller fillers as acetaminophen, experts in the substance-abuse arena have expressed major concerns about the availability of a medication that is up to 10 times more powerful than Vicodin and other powerful opioid pain pills, said the AP, which noted that the drug company Zogenix has indicated that it plans to apply for the marketing of a time-released version of the medication in the first half of 2012. Read more about the risks associated with prescribing opioids to treat pain in Psychiatric News.

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Kentucky Physicians Tackle Benzodiazepine Abuse

Because so many of their patients had been clamoring for the benzodiazepine Xanax (alprazolam), in some cases to abuse it, a Louisville mental health clinic has taken an unusual step—its physicians are no longer prescribing it, the New York Times reported on September 14.

In May, the White House also moved to curtail abuse of prescription drugs. It announced that the Food and Drug Administration would require manufacturers of opioid pain medications to train physicians in the use of these medications and to develop materials for patients on their appropriate use and disposal. Read more information about this federal initiative in Psychiatric News at http://pn.psychiatryonline.org/content/46/10/1.1.full.

And abuse of prescription drugs seems to be a serious problem among adolescents, a National Institute on Drug Abuse survey has found. Last year, for example, use of the prescription opioid oxycodone was 5 percent among 12th graders. For more on this issue see the APA journal Psychiatric Services at http://ps.psychiatryonline.org/cgi/reprint/62/1/107. 

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