Posted by admin on August 5, 2010 under Prescription Drugs | 
A new White House study found a 400 percent jump in prescription drug abuse between 1998 and 2008. Experts blame a lack of monitoring programs as well as Americans’ increasing unwillingness to bear even small pains.
Prescription Drugs Abuse - ASIPP Blog
Prescription drug abuse is not just on the rise – it has become a national crisis, according to a just-released White House study detailing a 400 percent increase in substance abuse treatment admissions for prescription pain relievers between 1998 and 2008.
The report underscores the need for regulation amid a culture that has become increasingly reliant on ever-more-powerful and addictive prescription drugs, say experts.
The non-medical use of prescription pain relievers is now the second-most prevalent form of illicit drug use in America “and its tragic consequences are seen in substance abuse treatment centers and hospital emergency departments throughout our nation,” says Pamela Hyde, administrator of The Substance Abuse and Mental Health Services Administration, in a statement.
The statistics are being released to highlight a problem that has become all too familiar through the high-profile deaths of such celebrities as Michael Jackson and Anna Nicole Smith. But the problem affects all ages and socioeconomic strata, says Dr. Scott Glaser, president of Pain Specialists of Greater Chicago.
From 1994 to 2003, the number of prescriptions for controlled substances rose from 22 million to 354 million annually, says Dr. Glaser. The number of admissions for misuse of prescription painkillers to hospital emergency rooms rose from some 40,000 in 1994 to over 300,000 in 2008, he adds.
“There has been a strong push among doctors in recent years to be more aggressive in addressing pain,” he notes. “This has led to the dramatic increase in opiates such as morphine, but the problem is there hasn’t been a whole lot of science to go along with that.”
The abuse of these strong drugs is an indication of a much more widespread cultural problem, says addiction specialist Clare Kavin of The Waismann Method, a treatment center for opiate dependency, which has treated many celebrity addicts.
“We are in a culture of immediate gratification and nobody will put up with even the slightest discomfort anymore,” she says. This underlying attitude leads many patients to push for stronger painkillers when lower strength – but non-addictive – drugs would have sufficed in the past, she adds.
“We are in a perfect nightmare,” says Andrea Barthwell, who has advised the White House on national drug policies. Many of the factors that have come together to fuel this explosive problem – such as the lack of effective monitoring of prescriptions not just between doctors, but between pharmacies, and from state to state – have been well known for years.
Glaser points out that a federal monitoring program was signed into law in 2005 but funding has languished ever since. Glaser and his colleagues from the American Society of Interventional Pain Physicians are just back from lobbying on Capitol Hill for $55 million to fund the program, which they say will pay for itself in five years.
Currently some 37 states have some form of monitoring, Glaser says, but they are inconsistent and lead to widespread abuse. He points to widespread practices such as:
- Easy access to prescription drugs through the Internet
- Caravans of people crossing state lines – Florida is well known for its open-door clinics with easy access to drugs
- Street sales fueled by lax oversight
- Teens selling prescription drugs to each other
The increasing potency of presciption drugs can lead to what Ms. Barthwell calls a “frightening and unprecedented scenario”: “In the past, the number of people exposed to opiate-level highs was very narrow,” she says. “But now, with a wide cross-section of the population for the first time experiencing this kind of dependency, we are seeing a record number of people turning to heroin when they can no longer afford the more expensive prescription drugs.”
The data released Thursday highlight “how serious a threat to public health we face from the abuse of prescription drugs,” said Gil Kerlikowske, National Drug Policy Director, in a statement. “The spikes in prescription drug abuse rates captured by this study are dramatic, pervasive, and deeply disturbing,” he adds.
Posted by admin on August 4, 2010 under Healthcare, Prescription Drugs |
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The Hill HealthWatch - ASIPP Blog
By Julian Pecquet – 06/28/10 07:56 PM ET
More than a hundred pain management specialists are in Washington this week to warn lawmakers about the dangers of prescription drug abuse.
The physicians — members of the American Society of Interventional Pain Physicians (ASIPP) — want lawmakers to appropriate $55 million over the next five years to help states collect data on consumers who “doctor shop” and on physicians who over-prescribe or incorrectly prescribe pharmaceuticals.
“There are many states now where there are more young people who die from prescription drug abuse than die from car accidents — and that’s the first time in history,” said David Kloth, past president of the association and a Connecticut pain management doctor.
The physicians want Congress to reauthorize a 2005 bill providing grants to states that collect prescription drug information and share it with physicians and pharmacists — and law enforcement officials when there’s an investigation — while protecting patients’ privacy. Rep. Ed Whitfield (R-Ky.), an original sponsor of the bill, is expected to introduce legislation shortly.
Despite widespread agreement that prescription drug abuse is a serious problem — the 2005 law passed by unanimous consent in the Senate and by voice vote in the House — finding money to fight the scourge has not been easy.
No funds were appropriated until last year, Kloth said, when the Obama administration set aside $2 million in the Federal Omnibus Spending bill for the program, known as the National All Schedules Prescription Electronic Reporting (NASPER).
Kloth said Capitol Hill sources have told ASIPP that Rep. Hal Rogers (R-Ky.) has blocked appropriations for the grants in the past. Rogers, the commonwealth’s former attorney general, supports a monitoring program that’s more focused on law enforcement and may fear NASPER would compete for funding, Kloth said.
Rogers’s office denied any blocking of grants and defended the lawmaker’s commitment to prescription drug abuse.
“Congressman Rogers has been a leader in the fight against the epidemic of prescription drug abuse for a decade, and while it’s true we disagree with the NASPER approach, to say the congressman has ‘blocked’ funding for the program is simply not true. If that were the case, the millions of dollars appropriated for the program over the years would not be established law today. Congressman Rogers believes NASPER is a duplicative program propped up by the pain physician lobby and six years too late. Instead, he has championed state-sponsored prescription drug monitoring programs, supported by the Department of Justice,” said Rogers’s spokeswoman Stefani Zimmerman.
To date, 41 states have monitoring programs in place, according to ASIPP, although six are not operational.
However, many states do not meet NASPER standards — failing, for example, to monitor prescriptions electronically; only covering certain drug categories; or giving pharmacies more than seven days to submit information.
Only two states — Kentucky and Connecticut — are attempting to share information among states, which ASIPP says is necessary to prevent drugs abusers from stocking up on pills in states such as Florida that have laxer standards.
“Fragmented funding of multiple unauthorized programs will only create confusion among states applying for funding,” ASIPP says in a fact sheet on the NASPER program, “as well as both [the departments of Justice and Health and Human Services] as they try to administer similar programs.”
The group is advocating for other issues as well:
• Healthcare reform: The law incorporates several provisions of the National Pain Care Policy Act, but they need to be appropriated. In particular, ASIPP wants funds allocated for an Institute of Medicine conference on pain next year and a training grant program for medical schools and other entities to educate and train healthcare professionals in pain care.
• Physician payments: A permanent repeal of Medicare’s Sustainable Growth Rate formula.
• Ambulatory Surgery Center payments: ASIPP wants higher reimbursement rates for surgical procedures performed outside of hospitals.
Posted by admin on June 28, 2010 under Prescription Drugs |
ASIPP
They’re often called doctor shoppers, border hoppers, pharm-aholics and even hit-and-runners. They count on states’ lack of communication and exploit professionals whose job is to heal, hurting themselves and feeding others’ addictions through such feats.
They’re prescription painkiller addicts and, like other drug addicts, often go to extreme measures to get their fix. It’s not a new problem, just one that’s recently become more visible with high-profile celebrity deaths being caused by prescription pill overdoses.
“The least fun part of my job is managing medications,” said Connecticut-based pain physician Dr. David Kloth, who referred to Michael Jackson — formerly the King of Pop — as the King of Drug Popping. “You are suspicious of everybody — it’s sad, but everyone is painted with the same broad brush.”
It may be sad, but it’s what doctors face every day. Pain pill-related deaths have risen significantly over the years, with overdose deaths becoming the second leading cause of unintentional injury death in 2002, just behind motor-vehicle injuries, according to a Centers for Disease Control and Prevention (CDC) study. This increased death rate stems from prescription drugs known as opioid analgesics — powerful, addictive drugs like OxyContin and Vicodin that produce heroin-like effects — that were increasingly prescribed in the 1990s to treat pain.
“Their potential for misuse was underestimated, and opioid analgesics quickly became the most popular category of abused drugs,” the CDC report stated.
In an attempt to track patients’ prescriptions and prevent double dipping between doctors — and states – many states have created prescription drug monitoring programs through federal funding sources. As it stands, 41 states have passed laws to create some type of program, but some states with multiple nearby neighbors — like Maryland, Arkansas and Nebraska — don’t have any such law or bills pending.
“You need to know this information when you have a patient you’re concerned about,” Kloth said, adding that prescription drug abuse can often contribute to social ills such as divorce, child abuse and neglect. “The stories are endless.”
Under the National All Schedules Prescription Electronic Reporting Act (NASPER) — signed by President George W. Bush in 2005 — more than $50 million has been given to states to enact programs that allow doctors and other authorized users, like police, to access patient records. Though the NASPER legislation called for $50 million in funding, to date it has received $2 million as a result of denials by the Appropriations Committee.
The law’s aim is to have a coordinated national system that monitors an array of controlled substances — all those in Schedules II, III and IV (e.g., cocaine and anabolic steroids), as defined by the U.S. Drug Enforcement Administration and the U.S. Food and Drug Administration. It permits states to exchange sensitive data with each other to deal with border hoppers, doctor shoppers and the like.
“Patients moving from one jurisdiction to another (as in cases involving Virginia, the District of Columbia and Maryland) will typically be able to obtain multiple prescriptions by merely crossing state lines,” a NASPER fact sheet stated. “The conscious and more prevalent unconscious misuse of Schedule II, II and IV controlled substances, are a national problem that cannot be effectively addressed on a state-by-state basis.”
But states are making progress toward implementing such monitoring programs, said Joanee Quirk, who runs the Nevada Prescription Drug Monitoring Program. “[States] have a common bond, but we all run our systems a bit differently,” she said.
Those differences can sometimes create strife between states, she said. For example, unlike many other states, Vermont doesn’t allow outside law enforcement agencies to access its system,
NASPER proponents are preparing to file for reauthorization of the bill with Congress, the effects of which should allow states to create (if they haven’t already) and standardize their programs, said American Society of Interventional Pain Physicians CEO Dr. Laxmaiah Manchikanti. “We are progressing toward better monitoring and it’s becoming more doctor-friendly,” he said.
Right now, Manchikanti, whose practice is in a small Kentucky town, has to tap into other states’ databases to get information on a patient, he said. While a national database is becoming a reality for Manchikanti, its full implementation could take up to 10 more years, he said.
The U.S. Government Accountability Office in 2002 reported that state monitoring programs do indeed provide an effective tool to stem the growing problem of illegal diversion of prescription drugs, and noted that they offer quick access to comprehensive information, which often deters abusers from doctor shopping within the state.
“Further, only a few programs operate proactively, while most operate reactively,” a NASPER fact sheet stated. “Incidents of drug diversion, however, are on the rise in neighboring states, indicating the problem is proliferating or shifting to states without monitoring programs.”
Such a program recently came in handy for Kloth, who, after hearing a litany of excuses from one patient — from running out of medication early, losing the bottle and saying his wife accidentally washed it — checked the state database and found the patient had seen 35 doctors and was prescribed medications at 25 pharmacies. “It’s very easy to get addicted to these medications,” Kloth said. “The drugs … will take hold of you.”
In Nevada — a typically transient state — the state prescription drug monitoring program is run by the state board of pharmacy and anyone who prescribes a controlled substance is required by law to report that information to them, said Quirk, who runs the program.
“The real key here is it is just a tool,” Quirk said. “We don’t want a doctor to base prescribing or not prescribing on these reports, but to look at the big picture.
“We don’t know the big picture, but the doctor may,” she said. “That’s why we have this incredible tool they can use.”
Posted by admin on June 27, 2010 under Prescription Drugs |
FROM: AMERICAN SOCIETY OF INTERVENTIONAL PAIN PHYSICIANS
81 LAKEVIEW DRIVE
PADUCAH, KY 42001
www.asipp.org
Rubenstein Public Relations
Contact: Adam Mazur / Tel: 212-843-8073
Email: amazur@rubensteinpr.com
Recent O.D. of Brittany Murphy and J&J Heiress Casey Johnson Underscores Need For Tougher Drug Monitoring
NEW YORK– January 15, 2010 – There is a grim fact that ties together the recent deaths of Clueless actress Brittany Murphy and heiress Casey Johnson, as well as last summer’s passing of “King of Pop” Michael Jackson and before that actor Heath Ledger. You could even go back to the real “King” Elvis Presley’s death (he’d have turned 75 this month if he were alive) – despite recent studies suggesting a decrease in non-medically administered prescription drug use, the number of Americans who die as a result of abuse is still alarmingly high.
And it’s no coincidence that it seems like another high profile person in this country is dying of matters related to the mismanagement of prescription drugs such as OxyContin, Xanax and Propofol – each and every week.
The American Society of Interventional Pain Physicians (ASIPP), the organization which proposed the National All Schedules Prescription Electronic Reporting Act (NASPER), a bill that allows for nationwide drug monitoring to help stem the tide of rampant prescription drug abuse, is calling for much tougher drug monitoring, training and testing on a national level.
“Prescription drug abuse in this country is out of control and I can safely predict the list of high-profile deaths like Brittany Murphy and Casey Johnson is only going to get longer because too many people including regular citizens have had fairly easy access to this excess for far too long,” remarked Dr. David Kloth, ASIPP past president and board member. “Americans have to wake up and realize that we are facing a national epidemic that is killing our loved ones every day – not just celebrities and socialites.”
“The problem is not the medication alone, but rather those prescribing the drugs without adequate control and training and patients who abuse the medication and do not follow their doctors’ orders. That’s why we propose more rigorous standards and certification for physicians dispensing pain medication otherwise, patients will continue to abuse and the overdoses and deaths will continue to mount,” added Kloth.
According to the U.S. Drug Enforcement Administration, nearly 7 million Americans are abusing prescription drugs — more than the number abusing cocaine, heroin, hallucinogens, Ecstasy, and inhalants, combined and twenty-five percent of drug-related emergency department visits are associated with abuse of prescription drugs.
ASIPP says that physicians who prescribe pain medications need to be properly trained. These medications can only be prescribed by a physician with an active DEA license in the state within which they are working or prescribing. Additionally, patients must be informed about the dangers of over medicating, which can lead to a potentially fatal overdose.
About The American Society of Interventional Pain Physicians
ASIPP’s mission statement is to promote the development and practice of safe, high quality, cost-effective Interventional Pain Management techniques for the diagnosis and treatment of pain and related disorders, and to ensure patient access to these interventions. Founded in 1998 by current CEO Laxmaiah Manchikanti, MD, ASIPP is a rapidly growing not-for-profit organization that supports the needs of physicians who practice Interventional Pain Management across the country.
Since its inception, the organization has had substantial impact on the practice of interventional pain medicine, resulting in an impressive list of major achievements. In 2005, ASIPP succeeded in passing The National All Schedules Prescription Electronic Reporting Act (NASPER), which provides and improves patient access to quality care, and protects patients and physicians from the deleterious effects of controlled substance misuse, abuse and trafficking. ASIPP is headquartered in Paducah, KY and currently has over 5,000 members. For more information, visit www.asipp.org, call 212-843-8073 or email amazur@rubensteinpr.com.
