The Problem
  • Opioid Rx's increased >10-fold over last 15 yrs; US consumes 70% of world supply
  • Unintentional deaths due to prescription opiate abuse has quadrupled in the last 7 yrs
  • Leading cause of accidental death in 17 states
  • ER visits for Rx drug abuse has caught up with the number seen for illegal drugs
  • The numbers above reflect CDC date for 2006 (most recent available)
  • 2008 estimate - unintentional Rx opiate deaths now exceed motor vehicle deaths
  • What do all these names have in common?
    • Heath Ledger
    • Anna Nichole Smith
    • Michael Jackson
    • Brittany Murphy
    • Chad Glesner
The Solution
  • Prescribers, dispensers, patients & community must treat pain but confront abuse
  • Appropriate treatment plans are the cornerstone of abuse prevention
    • Contracts
    • Endpoints
    • Non-drug therapy
  • Identification and prosecution of small fraction of prescribers, dispensers and patients who are part of a criminal enterprise and endanger patients and others in the community
  • Pharmacist role:
    • Run a MAPS report on any controlled substance patient unknown to you
    • Suggest pain control specialist evaluation when dose >120 mg morphine equivalent/day
    • Refuse prescriptions when a patient <65 yo is being treated with opioids:
      • For more than 6 weeks by two or more providers
      • Signs of inappropriate use of controlled substances