This article is more than 5 years old. Information may no longer be current.

State drug monitoring programs identify patients misusing opioids

Prescription drug monitoring programs can be used by states to generate population-based measures for prescribing controlled substances, as well as actions that could indicate their misuse, according to recently published data by the CDC.

“Every day, 44 people die in American communities from an overdose of prescription opioids and many more become addicted,” Tom Frieden, MD, MPH, CDC director said in a press release. “States are on the frontline of witnessing these overdose deaths.  This research can help inform their prescription overdose prevention efforts and save lives.”

Tom Frieden

Researchers analyzed data from the 2013 Prescription Behavior Surveillance System (PBSS) to assess trends in prescription opioid pain relievers, benzodiazepines and stimulants across California, Delaware, Florida, Idaho, Louisiana, Maine, Ohio and West Virginia. According to a press release, these states represent approximately one-fourth of the nation’s population.

Across all included states, opioids were prescribed at twice the rates of benzodiazepines and stimulants.

Results demonstrated that disparities in prescribing practices by drug class were seen across all eight states: twofold for opioids, fourfold for stimulants, and almost twofold for benzodiazepines and eightfold for the muscle relaxant carisoprodol.

Rates of opioid prescriptions were highest among patients aged 45-54 years and 55-64 years, while prescription rates of benzodiazepine increased with age, according to the researchers.

Opioid prescription rates were highest overall in Louisiana. In Delaware, 1% of prescribers accounted for one in four opioid prescriptions, while in Maine it was one in eight. According to the researchers, these prescriptions are most likely written by general, family and internal medicine and midlevel practitioners.

The researchers noted that a good indicator of drug abuse is when a prescription is paid for in cash. Across five states that collected data on payment method, cash payment for controlled substance prescription varied almost threefold, and those paid for by Medicaid varied sixfold. 

A significant number of patients who were prescribed opioids had also been prescribed benzodiazepines.

Women were significantly more likely to be prescribed opioids and benzodiazepines compared with men. 

Determining the cause of prescription rate disparities by state is an important step to combating drug abuse and misuse, according to the researchers.

“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,” Debra Houry, MD, MPH, director of CDC’s National Center for Injury Prevention and Control, said in a press release. – by Casey Hower