The Ultimate Guide to Prescription Drug Abuse

The Ultimate Guide to Prescription Drug Abuse: The Problems and Solutions

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  • LEARN MORE  about how every 4 minutes someone is sent to treatment
  • HELP STOP  doctor shopping and diversion
  • DISCOVER  how the current administration says it will reduce drug use by 15%

What Does the e-Prescribing Landscape Look Like?

The e-prescribing market is quite valuable, apparently.

By 2017, the market will likely be worth $794 million worldwide. It is expected to grow at a compound annual growth rate of 26 percent over the next four years, according to a report by MarketsandMarkets, a US-based global market research and consulting company.

E-prescribing systems allow healthcare professionals to submit and receive prescriptions electronically either through standalone e-prescribing software or EHR-integrated e-prescribing modules. E-prescribing is meant to reduce care costs, improve efficiency, and, above all, enhance patient safety. It allows healthcare providers to transmit prescriptions electronically and receive renewal authorizations through their EMR. E-prescribing is fast replacing paper prescriptions and is an integral part of the Centers for Medicare and Medicaid’s (CMS) EHR Incentive Program and “Meaningful Use.”payers

In the United States, e-prescribing is encouraged by federal incentive programs, such as the EHR Incentive Program, which focuses on the meaningful use of electronic health record software. Standards for “Meaningful Use” are defined by the Centers for Medicare and Medicaid Services – and e-prescribing is an important component of those standards. It not only helps improve patient health but overall patient safety as well.

“Major players such as Surescripts, Cerner Corporation, Allscripts, Athenahealth, iMedX, DrFirst, Emdeon, eClinicalWorks, Practice Fusion and Bizmatics are mainly focusing on the development of electronic prescription solution as standalone or as integrated module of Electronic Health Records / Practice Management.”

To read more about the Markets and Markets report, click here.

UPDATED:  The New England Journal of Medicine recently published some early results of the Meaningful Use Program. Here is an excerpt of the findings as of May 2012:

  • A total of 62,226 eligible professionals had attested to meaningful use under the Medicare program. This represents 12.2% of the estimated 509,328 eligible physicians in the United States, including 9.8% of specialists and 17.8% of primary care providers (PCPs).
  • Meaningful Use of Electronic Health Records, April 2011 through May 2012.depicts the cumulative number of attestations, according to month. The attestation rate varied substantially according to states. Family practitioners had the highest number of attestations (with 14,122), and PCPs comprised 44.0% of all attestations.
  • Providers used EHRs from 310 vendors, although the top 5 vendors (Epic, Allscripts, eClinicalWorks, GE Healthcare, and NextGen) accounted for 58.5% of attestations, and 15 vendors accounted for 80.1%.

To read more about the NEJM report, click here.


Everything You Need to Know About Proposition 46

Election day is right around the corner!

It is just one week away….

California residents are most likely already aware of Prop 46, which is the most hotly debated and contested ballot initiative this year.

For those outside of California, it is still an interesting debate to follow.

So what is Proposition 46?

It is a ballot initiative in California that addresses several health care reforms.

There are actually three different initiatives all rolled into one.

1) Increase the limit on damages for pain and suffering.

▪ The projected raise on medical malpractice suits would go from $250,000 to $1.1 million. This is the cap on the amount of damages for pain and suffering that can be awarded in a medical malpractice lawsuit. The cap would be indexed to inflation in subsequent years.

2) Require random drug and alcohol testing of doctors.
▪ Hospitals administrators would conduct random drug and alcohol tests to doctors affiliated with the facility. Subsequently, the state medical boards must take specific disciplinary action, including license suspension, if a doctor is found to have been using drugs or alcohol on duty or refuses to follow the drug and alcohol testing protocol.

3) Mandate that health professionals consult a statewide drug database – known as CURES – before issuing certain medications to patients to prevent “doctor shopping.”
▪ All health professionals, including pharmacists, would have to check the statewide prescription drug monitoring program (PDMP) before dispensing potentially abusive drugs to a patient for the first time.  The CURES system can determine if the patient already has an active prescription with other physicians or at other hospitals.

As mentioned before, this Proposition has become the most hotly debated and contested initiative. Thus far, supporters have raised $9.2 million and spent $7.4 million, while opponents have raised $57.6 million and spent $54.2 million.  The majority of financial supporters include trial lawyers, attorneys, and consumer watchdog groups.  The opponents include the California Medical Association and every other group representing doctors in California, as well as all of the major Insurance companies.
At this point, it seems unlikely that Prop. 46 will pass. Most of the major newspaper in the state, including the Los Angeles Times and Orange County Register, have lined up against the measure.

According to the Legislative Analyst’s Office, raising the malpractice cap would likely increase total health care spending by 0.1 percent to 0.5 percent. For state and local government, it said the increase could amount to “several hundred million dollars annually.”

Why do we oppose Prop 46?

Prop 46 is essentially well-intentioned.  The source of Prop. 46 came from a tragic event – the death of two young children because of a driver high on prescription drugs.  And the father’s efforts to bring this reform bill through the political process is certainly noble.

However, the costs are too onerous on doctors and health systems with the medical malpractice suits.

As for the random drug testing for physicians, it is certainly a good idea, but the design of the execution here is flawed.  They would be required to submit to drug testing 12 hours after a medical error or risk suspension. But complications from malpractice can take weeks, even years, to appear. It will create another layer of bureaucratic red tape, and will be difficult from an administrative standpoint.

The biggest issue here comes from the mandatory consulting of the PDMP.  The database in California is CURES, or the Controlled Substance Utilization Review and Evaluation System. It has existed in California for over 40 years.

Despite that, currently 5% of all 100,000 California physicians currently use CURES on a regular basis.  It has been the victim of budget cuts almost every year.  There is now one employee to manage the CURES database, for the entire state of California. It has proven to be consistently inaccurate. The data cannot be verified.  The data is not in real-time.  It can take up to 4-6 weeks for a prescription to be entered into the system.  So a doctor shopper could realistically continue to procure drugs without anybody knowing.  CURES is not really a tool for prevention at all.

As always, the issue is that a government built and run system is not going to be an effective system over the long term. It will always be the subject of political debates, budget cuts, and mismanagement.

We need better technology to tackle this highly important issue in the state. A private solution is the only way to really communicate between physicians and pharmacists, to track transactions at the point of prescribing, and to monitor the system effectively.

Check out ScriptGuard at for more information.


The Role of Pharmacists in Preventing Prescription Drug Abuse

Pharmacists dispense medications and can help patients understand instructions for taking them. By being watchful for prescription falsifications or alterations, pharmacists can serve as the first line of defense in recognizing prescription drug abuse. Some pharmacies have developed hotlines to alert other pharmacies in the region when a fraudulent prescription is detected. Prescription drug monitoring […]

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Alarming Prescription Drug Abuse Statistics

We all need to be better educated. Prescription drugs and over-the-counter drugs are dangerous when used illegally. We need to do a better job of understanding the risks associated with prescription drug abuse and prescribing habits. We need to understand that the issue is costing the healthcare system over $2 billion annually. More importantly, parents […]

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Why Do Government Systems Always Fail Us?

The faults of are still fresh in the memory.  The rollout was a complete mess. And while the government is trying to claim fixes in the system, and an easier registration process, the damage cannot be truly undone.  At least to this point, its greatest legacy has been a botched rollout. Really though, […]

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A comprehensive and systematic approach to addiction treatment

17 people die from prescription drug overdoses every day in the United States. Drug deaths from opioid abuse increased for the 12th consecutive year. Clearly we are in the midst of an epidemic. Which is why it is encouraging to hear when acute care hospitals take an active position in preventing opioid overdoses.  And create a comprehensive and systematic […]

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Why We Should Be On Alert for Rx Drug Abuse

The risks for addiction increases when prescription drugs are used in ways other than as prescribed. Teenagers are especially at risk for abusing prescription drugs. They are more likely to obtain drugs in illegal ways.  In 2012, 24% of teens surveyed said they have taken a prescription drug without a doctor’s prescription. Teenagers like to experiment with […]

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The Importance of Prescription Records

Anybody who has ever visited a hospital before has a medical record of some sort.  Which accounts for pretty much all of us who were born in a hospital. A medical record is simply a record of a patient’s health and medical history. Depending on the level or need of care a patient has, records may […]

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Top 10 Prescription Guidelines

  A list of guidelines has been developed for health agencies in dealing with prescription drug abuse. They include the following 10 items: Look for and treat emergencies. Use best judgment when treating pain. These recommendations follow legal and ethical advice. Have only one provider and one pharmacy for helping you with pain. Do not prescribe pain […]

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The case of West Virginia and too many doctor shoppers

A state panel sent more than 2,500 letters to medical professionals across West Virginia, warning that their patients could be “doctor shopping” for prescription drugs. West Virginia continues to be Ground Zero for the prescription drug abuse epidemic. The state’s Board of Pharmacy committee discovered hundreds of patients who were receiving pain-pill prescriptions from as many as 13 […]

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