Opioid prescription drug monitoring programs (PDMPs) are driving more people toward heroin use, a recent research at Columbia University (CU) has indicated. The researchers at CU’s School of Public Health reviewed 17 studies and discovered that as prescriptions run dry, people move to more potent street drugs.
Although 10 studies found that post implementation of drug monitoring programs, there were reduction in opioid overdose deaths, three found that with restricted opioid prescribing heroin use and overdose deaths have increased. The study was published in the Annals of Internal Medicine in May 2018.
PDMPs are used by physicians and pharmacists to identify doctor shopping behavior, over-prescription rates and risk of misuse to help curb the opioid epidemic. These programs are either in place or passed by legislation to start afresh in all 50 states and the District of Columbia. According to lead author David Fink, it is important to understand if these programs are instrumental in alleviating the number of opioid overdose cases.
At places where the programs were effective, the researchers found that the databases was updated at least once a week and there were well-monitored systems for authorization. Additionally, the system was also updated with those drugs that do not feature on the Drug Enforcement Administration’s (DEA) list of scheduled controlled substances.
Co-author Silvia Martins was of the opinion that the “programs aimed at reducing prescription opioids should also address the supply and demand of illicit opioids.” Consequences like people substituting opioids with heroin shouldn’t go unnoticed.
Heroin use often begins with prescription opioids
Many people addicted to opioids progress to heroin use as it’s cheaper and easily available. Moreover, it doesn’t require a prescription. A recent paper even suggested that after the introduction of OxyContin in 2010, “each prevented opioid death was replaced with a heroin death.” Fentanyl use has also increased in recent years and PDMPs are not yet equipped to track or control its rapid rise.
Patients are generally prescribed opioids after a surgery or when they are in deep pain from some chronic illness. But they are often not educated about the potential harm of misuse and abuse by them and their families. Some patients might be prescribed unnecessary refills when they do not need them.
A recent survey by Mayo Clinic established that a majority of patients (63 percent) who were prescribed opioids after surgery did not use them and only 8 percent disposed their leftover medications. The leftover pills could be misused or ingested by children and pets at home.
The monitoring of database necessitates that the doctors check the number of prescriptions being written, the duration for which they are being prescribed, and types of opioids being given to the patients. Additionally, patients should be educated about safe storage and disposal practices.
Recovering from opioid addiction
Opioids are potent drugs which not only numb pain, but also produce a euphoric effect. Their long-term use can cause tolerance and dependence. Addiction to opioids can ruin a person’s life affecting his/her psychological and physical health in various ways.
The risk of discord in relationships, loss of productivity at work and school due to daytime sleepiness and absenteeism, as well as incidents of driving under the influence, unsafe sexual practices and violence also increase. It is important that an individual addicted to opioids seeks support from a certified drug abuse clinic and avails the best drug abuse facilities at the earliest.