19 October 2015

US needs improved narcotic prescribing practices

Improved prescribing practices could help reduce narcotic painkiller abuse and overdose deaths from these drugs, a new U.S. government study says.

An analysis of prescription drug-monitoring programmes in eight states found that a small number of doctors were responsible for most narcotic painkiller prescriptions, according to U.S. Centres for Disease Control and Prevention researchers.

Drug overdose is the leading cause of injury-related death in the United States. Most of those deaths stem from abuse of prescription pain drugs such as Vicodin and OxyContin, stimulants and sedatives/tranquilisers, according to the CDC.

Read: 1 in 5 teens abuses prescription meds

"Every day, 44 people die in American communities from an overdose of prescription opioids and many more become addicted," CDC Director Dr Tom Frieden said in an agency news release.

Heavy prescribers

"States are on the frontline of witnessing these overdose deaths. This research can help inform their prescription overdose prevention efforts and save lives," Frieden said.

The CDC researchers analysed 2013 data from prescription drug-monitoring programmes in California, Delaware, Florida, Idaho, Louisiana, Maine, Ohio and West Virginia, which represent about one-quarter of the U.S. population.

The study found a small number of doctors who were heavy prescribers. For instance, the top 1 percent of prescribers wrote 25 percent of narcotic prescriptions in Delaware, compared with about 12 percent in Maine.

Also, prescribing practices varied widely among states, even though the conditions these drugs are meant to treat occur at similar rates, the researchers said. Doctors in some states prescribed roughly twice as many narcotic painkillers and tranquiliser/sedatives as doctors elsewhere.

Read: 'Tamper-proof' narcotic painkillers may curb abuse

Stimulants, which include Adderall and Ritalin, were prescribed four times more often in certain states than others, the CDC report said.

In all eight states, the report said, narcotic painkillers were prescribed twice as often as stimulants or tranquilisers/sedatives, such as Ativan or Xanax.

Risks and benefits

Also, people who received narcotic prescriptions often received tranquiliser/sedative prescriptions, too, even though that put them at risk for harmful drug interactions, the CDC said.

The study also found that the percentage of cash payments for controlled substance prescriptions an indicator of abuse varied nearly threefold among the five states that collected such data.

The findings, published in the issue of the CDC's Morbidity and Mortality Weekly Report, highlight the need to improve prescribing practices, particularly for narcotics, the study authors said.

"A more comprehensive approach is needed to address the prescription opioid overdose epidemic, including guidance to providers on the risks and benefits of these medications," Dr Debra Houry, director of CDC's National Centre for Injury Prevention and Control, said in the news release.

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