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Unintentional Poisoning: CDC Research & Activities

From the Centers for Disease Control and Prevention:

CDC has developed an issue brief that summarizes the most recent information about deaths and emergency department visits resulting from drug overdoses. This brief includes information on overdose trends, the most common drugs involved, and the regions and populations most severely affected. Recommendations on how health care providers, private insurance providers, and state and federal agencies can work to prevent unintentional drug overdoses are also included.

During 1999–2006, the number of poisoning deaths in the United States nearly doubled, largely as a result of deaths involving prescription opioid painkillers. CDC researchers found that, in 2006, the rate of poisoning involving opioid painkillers in Washington state was significantly higher than the national rate. Methadone was involved in almost two -thirds of these deaths.

While types of drugs involved in prescription drug overdose deaths can be determined from medical examiner and emergency department data, the patterns of prescription use leading up to these overdoses have not been described. To help in this effort, CDC Injury Center scientists are conducting a study is to compare the prescriptions used among people who died of drug overdoses with the prescription use of a control group of other users of controlled substance prescription drugs (CSPD). This project will link information from the New Mexico prescription drug monitoring program (PDMP) and the New Mexico state medical examiner. Risk factors to be examined will include prescriptions for specific drugs, the number of prescriptions, providers, and pharmacies, and overlapping prescriptions. Study results are expected in 2010.

Posted: 3/23/2010 12:04:00 PM

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Pain Management Failing as Fears of Prescription Drug Abuse Rise

From ScienceDaily:

Millions of Americans with significant or chronic pain associated with their medical problems are being under-treated as physicians increasingly fail to provide comprehensive pain treatment -- either due to inadequate training, personal biases or fear of prescription drug abuse.

A pharmaceutical expert in pain management in the College of Pharmacy at Oregon State University says the issue is reaching crisis proportions, and in two new professional publications argues that health consumers must be aware of the problem and in many cases become more informed, persistent advocates for the care they need and deserve.

Adequate pain treatment has always been a concern, said Kathryn Hahn, a pharmacist, affiliate faculty member at OSU and chair of the Oregon Pain Management Commission, in part because it's not a major part of most physician's medical training. Even though they will often see a stream of patients with pain problems throughout their careers, they may only get a few hours of education on the use of opioids in medical school.

In recent years, the problems have dramatically increased due to concerns about prescription drug abuse, in which drugs such as oxycodone are often stolen from homes or otherwise misused. In a 2006 survey of teenagers, 62 percent said prescription pain relievers were easy to get from their parents' medicine cabinet. One analysis concluded that admissions to federally supported treatment programs for prescription opioid abuse increased 342 percent from 1996 to 2006 -- a comprehensive problem that is also estimated to cost insurance companies tens of billions of dollars a year.

"Surveys show that at least 30 percent of patients with moderate chronic pain and more than 50 percent of those with severe chronic pain fail to achieve adequate pain relief," she wrote in one article. "The economic impact of acute and chronic pain exceeds $100 billion per year in the U.S. alone."

Community pharmacists, she said, are often on the front lines of this issue and constantly see individuals with pain concerns and inadequate pain management by their health care providers. They can often help serve as advocates, improve lines of communication between patients and their doctors, and help patients manage their prescribed drug therapies.

Health insurers also have an important role to play in reducing prescription drug abuse, Hahn said. They can help educate physicians on appropriate use, advocate for universal precautions in use of pain medicines, restrict off-label uses of readily diverted opioids, pay for multidisciplinary pain management programs, and take other steps.

Posted: 1/6/2010 9:11:00 AM

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