A new study evaluates a new tool used to detect drug-seekers who venture into the ER in order to obtain prescription medications.
Emergency room department staff and physicians do encounter the occasional so-called patient complaining of pain who is actually a prescription painkiller addict seeking a fix. Therefore, clinicians have been trying to establish an effective method or tool for detecting drug-seekers.
An analysis – “Clinician Impression vs. Prescription Drug Monitoring Program Criteria in the Assessment of Drug-Seeking Behavior in the Emergency Department” – of emergency providers’ prescribing patterns, published in Annals of Emergency Medicine, found when using data from a computerized state prescription drug monitoring program (PDMP) that physicians were fairly accurate in assessing which patients were drug-seekers.
PDMPs are state-based centralized data collection programs that record combinations of controlled substance medications for certain classes of prescription medications that are typically abused.
Prescription painkillers typically consist of opioids, a psychoactive chemical that resembles morphine in its pharmacological, analgesic effects. Opioids are used to decrease the perception of pain, the reaction to pain; temporarily aiding in tolerance by binding to associated receptors primarily in the central and peripheral nervous systems.
Painkillers are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain. If taken exactly as prescribed by medical professionals, opioids can manage pain effectively. The problem occurs when they are abused.
A dependence – an addiction – can develop over time, which is detected after an abrupt discontinuation of medication. Abuse of opioid painkillers – like hydrocodone and oxycodone – can have several side effects including sedation, disorientation, respiratory depression, and death.
Therefore, the prescribing of painkillers is controlled and limited. However, desperate drug-seekers will often venture into hospitals hoping to be treated or prescribed with painkillers.
In order to establish their results, researchers – led by Dr. Scott G. Weiner, of Tufts Medical Center in Boston, Massachusetts – compared emergency physicians’ impressions of drug-seeking behavior to data contained in a state PDMP on 544 patient visits to emergency departments.
Emergency physicians assessed 35.6 percent of patients as drug-seekers, while the PDMP assessed 23.2 percent of patients as drug-seekers, reports the American College of Emergency Physicians.
Drug-seekers were defined in this study as patients who had four or more opiate prescriptions from four or more providers in 12 months.
After reviewing data in the PDMP, emergency physicians changed their prescribing plan for nearly 10 percent of patients.
Dr. Weiner states, “Data from the PDMPs can provide important objective criteria to help better inform prescribing decisions.”
Data from the PDMP reveals which patients who request medication specifically by name, the number of visits for the same complaint, and allows doctors to see if the patient has a suspicious history, thus making it easier to isolate drug-seeking behavior.
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