Reduce Over-Prescription of Prescription Drugs - Revision history

Snkennedy3327: Snkennedy3327 moved page Reduce Over-Prescription of Opioids to Reduce Over-Prescription of Prescription Drugs without leaving a redirect

2020-05-27T03:07:10Z

Snkennedy3327 moved page Reduce Over-Prescription of Opioids to Reduce Over-Prescription of Prescription Drugs without leaving a redirect

Snkennedy3327: Snkennedy3327 moved page Reduce Over-Prescription of Opioids to Reduce Over-Prescription of Prescription Drugs without leaving a redirect

2020-05-27T03:07:09Z

Snkennedy3327 moved page Reduce Over-Prescription of Opioids to Reduce Over-Prescription of Prescription Drugs without leaving a redirect

Snkennedy3327: Snkennedy3327 moved page Reduce Over-Prescription of Opioids to Reduce Over-Prescription of Prescription Drugs without leaving a redirect

2020-05-27T03:07:09Z

Snkennedy3327 moved page Reduce Over-Prescription of Opioids to Reduce Over-Prescription of Prescription Drugs without leaving a redirect

Snkennedy3327 at 21:47, 23 October 2019

2019-10-23T21:47:54Z

Snkennedy3327 at 19:39, 23 October 2019

2019-10-23T19:39:32Z

Snkennedy3327: Snkennedy3327 moved page Reduce Prescription of Opioids to Reduce Over-Prescription of Opioids

2019-10-18T20:16:05Z

Snkennedy3327 moved page Reduce Prescription of Opioids to Reduce Over-Prescription of Opioids

Billb at 21:36, 7 October 2019

2019-10-07T21:36:23Z

Billb at 21:35, 7 October 2019

2019-10-07T21:35:45Z

Billb at 21:33, 7 October 2019

2019-10-07T21:33:53Z

Ameyabhor at 06:30, 5 February 2019

2019-02-05T06:30:33Z

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-<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">'''''Return to'''&nbsp;[[Opioid_Top-Level_Strategy_Map|Opioid_Top-Level_Strategy_Map]]&nbsp; or&nbsp;&nbsp;[[ZOOM_MAP_-_Reduce_Prescription_of_Opioids|Zoom Map (Reduce Prescription of Opioids)&nbsp;]]&nbsp; or&nbsp; the [[ZOOM_MAP_-_Reduce_Access_to_Opioids|Zoom Map (Reduce Access to Opioids)]]''
+<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">'''''Return to'''&nbsp;[[Opioid_Top-Level_Strategy_Map|Opioid_Top-Level_Strategy_Map]]&nbsp; or&nbsp;&nbsp;[[ZOOM_MAP_-_Reduce_Prescription_of_Opioids|Zoom Map (Reduce Prescription of Opioids)&nbsp;]]&nbsp; or&nbsp; the [[ZOOM_MAP_-_Reduce_Access_to_Opioids|Zoom Map (Reduce Access to Opioids)]]''
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 #[http://catalyst.nejm.org/act-now-prescription-opioid-crisis/?utm_campaign=tw&utm_source=hs_email&utm_medium=email&utm_content=51100063&_hsenc=p2ANqtz-_oQWJ7-DxzFgvqArz6FRbZcZ6IGV9pybacNCcFzbO79WW05_bglhgesjejwFT992hRSFxknyMnqcTkzXYbtEhFGfokyDf4jl773soGbB7y_VGsB1k&_hsmi=51100063 [42]]
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-<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">'''''Return to'''&nbsp;[[Opioid_Top-Level_Strategy_Map|Opioid_Top-Level_Strategy_Map]]&nbsp; or&nbsp;&nbsp;[[ZOOM_MAP_-_Reduce_Prescription_of_Opioids|Zoom Map (Reduce Prescription of Opioids)&nbsp;]]&nbsp; or&nbsp; the [[ZOOM_MAP_-_Reduce_Access_to_Opioids|Zoom Map (Reduce Access to Opioids)]]''
+<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">'''''Return to'''&nbsp;[[Opioid_Top-Level_Strategy_Map|Opioid_Top-Level_Strategy_Map]]&nbsp; or&nbsp;&nbsp;[[ZOOM_MAP_-_Reduce_Prescription_of_Opioids|Zoom Map (Reduce Prescription of Opioids)&nbsp;]]&nbsp; or&nbsp; the [[ZOOM_MAP_-_Reduce_Access_to_Opioids|Zoom Map (Reduce Access to Opioids)]]''
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 #[http://catalyst.nejm.org/act-now-prescription-opioid-crisis/?utm_campaign=tw&utm_source=hs_email&utm_medium=email&utm_content=51100063&_hsenc=p2ANqtz-_oQWJ7-DxzFgvqArz6FRbZcZ6IGV9pybacNCcFzbO79WW05_bglhgesjejwFT992hRSFxknyMnqcTkzXYbtEhFGfokyDf4jl773soGbB7y_VGsB1k&_hsmi=51100063 [42]]
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-<div class="mw-parser-output"><div class="mw-parser-output">'''''Return to''' the [[Opioid_Top-Level_Strategy_Map|Opioid_Top-Level_Strategy_Map]] or&nbsp;[[ZOOM_MAP_-_Reduce_Prescription_of_Opioids|Zoom Map (Reduce Prescription of Opioids)&nbsp;]]&nbsp;or the [[ZOOM_MAP_-_Reduce_Access_to_Opioids|Zoom Map (Reduce Access to Opioids)]]''
+<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">'''''Return to'''&nbsp;[[Opioid_Top-Level_Strategy_Map|Opioid_Top-Level_Strategy_Map]]&nbsp; or&nbsp;&nbsp;[[ZOOM_MAP_-_Reduce_Prescription_of_Opioids|Zoom Map (Reduce Prescription of Opioids)&nbsp;]]&nbsp; or&nbsp; the [[ZOOM_MAP_-_Reduce_Access_to_Opioids|Zoom Map (Reduce Access to Opioids)]]''
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 #[http://catalyst.nejm.org/act-now-prescription-opioid-crisis/?utm_campaign=tw&utm_source=hs_email&utm_medium=email&utm_content=51100063&_hsenc=p2ANqtz-_oQWJ7-DxzFgvqArz6FRbZcZ6IGV9pybacNCcFzbO79WW05_bglhgesjejwFT992hRSFxknyMnqcTkzXYbtEhFGfokyDf4jl773soGbB7y_VGsB1k&_hsmi=51100063 [42]]
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-<div class="mw-parser-output">Return to the [[Opioid_Top-Level_Strategy_Map|Opioid_Top-Level_Strategy_Map]] or&nbsp;[[ZOOM_MAP_-_Reduce_Prescription_of_Opioids|Zoom Map (Reduce Prescription of Opioids)&nbsp;]]&nbsp;or the [[ZOOM_MAP_-_Reduce_Access_to_Opioids|Zoom Map (Reduce Access to Opioids)]]
+<div class="mw-parser-output"><div class="mw-parser-output">'''''Return to''' the [[Opioid_Top-Level_Strategy_Map|Opioid_Top-Level_Strategy_Map]] or&nbsp;[[ZOOM_MAP_-_Reduce_Prescription_of_Opioids|Zoom Map (Reduce Prescription of Opioids)&nbsp;]]&nbsp;or the [[ZOOM_MAP_-_Reduce_Access_to_Opioids|Zoom Map (Reduce Access to Opioids)]]''
 Reducing prescription of opioids contributes to reducing risk in multiple ways. First, it reduces the number of people who are beginning to use prescription opioids for legitimate prescribed reasons but who may begin to develop a dependence on opioids or a strong desire to keep using them when the specific medical need ends. Second, reducing the prescription of opioids will reduce the number of excess pills that are often diverted for inappropriate use.
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 == Effectiveness ==
 <div class="_">In a paper published by the National Safety Council, with a focus in looking at prescription opioids, doctors are beginning to prove that prescription opioids are not as strong as the public may seem. The National Safety Council ([http://www.nsc.org/pages/home.aspx nsc.org]) is a nonprofit organization whose mission is to save lives by preventing injuries and deaths at work, in homes and communities, and on the road through leadership, research, education and advocacy.<br/> &nbsp; When digging into whether or not a pain killer is effective or not, doctors look at the ''Number Needed to Treat.'' NNT is the number of people who must be treated by a specific intervention for one person to receive a certain effect. For example, when testing pain medications, the intervention is the dose of pain medication and the effect is usually 50 percent pain relief. Fifty percent relief of pain is considered effective treatment, allowing people increased functional abilities and an improved quality of life (Cochrane. org, 2014). So the question becomes, how many people must be treated with a certain dose of a medication for one person to receive 50 percent pain relief (effective relief)?<br/> &nbsp; A lower NNT means the medicine is more effective. A product with an NNT of 1 means that the medicine is 100 percent effective at reducing pain by 50 percent - everyone who takes the medicine has effective pain relief. A medicine with an NNT of 2 means one out of two, or 50 percent, of people who take the medicine get effective pain relief. An example of a medicine that would not be a good pain reliever would be one with a NNT equal to 10. In such a case, you would have to treat 10 people for one to receive effective pain relief.<br/> &nbsp; When comparing opioids versus over the counter pain medicines, we see a steep decline in the NNT. Most would assume that opioids would beat out over the counter pain relievers-- this happens to not be the case. In the paper, doctors state that over the counter pain relievers have a lower NNT than that of opioid pain medication. This can be seen in the diagram below.<br/> [[File:Screen Shot 2017-05-31 at 3.10.06 PM.png|Screen Shot 2017-05-31 at 3.10.06 PM.png]]</div> <div class="_">&nbsp;[http://www.nsc.org/RxDrugOverdoseDocuments/Evidence-Efficacy-Pain-Medications.pdf?utm_campaign=Advocacy%20:%20Rx%20Drug%20Overdose&utm_source=hs_automation&utm_medium=email&utm_content=14359125&_hsenc=p2ANqtz--rGDOmg26G3XFqlpBlzTdhUD6HeBCp9sVYabAUNAOTCZ5fNJ3Oi5AeQtO8TjiF0JIE0rVvK6GByIraVOjKP12epF3vxA&_hsmi=14359125 Evidence for the Efficacy of Pain Medications]<sup class="reference">[23]</sup><br/> &nbsp;</div> <div class="_">&nbsp;</div>
 = Promising Programs =
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 *''West Virginia -'' doctors are going to to be ranked based on how much they prescribe opioids<sup class="reference">[40]</sup>
-<br/> '''[https://www.communitycarenc.org/population-management/chronic-pain-project/ Project Lazarus]''' - A community-wide response to managing pain with lots of resources. ''One problem that patients and doctors both face is insurance coverage for non-opioid pain treatments. Options such as physical therapy, acupuncture, chiropractic care, and steroid injections, often have little to no coverage from insurers. Even when physicians are trying to reduce opioid prescriptions, insurance companies a thwarting the effort. In addition, for many who have been taking opioids for years to manage pain, alternative therapies are often not as effective, and there has been little research in finding an effective, non-addictive drug alternative to opioids''.<sup class="reference">[41]</sup><br/> <br/> '''Saliva Drug Screening''' – For multiple reasons, a saliva sample should be chosen over the more common urine sample to test for drugs present in the system.<sup class="reference">[42]</sup><sup class="reference">[43]</sup> Unlike urine, saliva tests cannot be adulterated, it can be administered rapidly, it has the ability to test for many things, it shows the metabolite drug and is cost-effective in the long run.<sup class="reference">[44]</sup> Some healthcare systems may consider cost an issue, but saliva tests are billed to the same code. <span style="color: #ff0000">[citation needed]</span><br/> ''Contact'': John Cribbs (john@nodrugsneeded.com)<br/> <br/> '''DEA Diversion Control Program (DCP)''' - This program is responsible for regulating and controlling more than 1.6 million DEA registrants involved in manufacturing, distributing, prescribing, and dispensing controlled prescription drugs (CPDs). DEA’s Diversion Control efforts are geared toward preventing the non-medical use of CPDs by providing education and training within the pharmaceutical and medical communities and pursuing those practitioners who are operating outside of reasonable medical standards. <sup class="reference">[45]</sup><br/> <br/> '''[https://labtestsonline.org/understanding/analytes/pharmacogenetic-tests/ Pharmacogenetics Test]''' -At $350 per test and only needed once in your life, this is a cost effective approach to ensure that patients receive an appropriate dose of pain medication.<sup class="reference">[46]</sup><br/> ''Contact'': John Cribbs (john@nodrugsneeded.com)<br/> <br/> '''[https://www.shatterproof.org/advocacy/state-by-state-information/prescriber-education Prescriber Education] -''' Physicians who prescribe opioid painkillers should receive training on the risks of overusing immediate release, extended-release, and long-acting formulations of pain medications. This training should be tied to the recently released ''CDC Guideline for Prescribing Opioids for Chronic Pain''.<sup class="reference">[47]</sup>
+<br/> <br/> '''Saliva Drug Screening''' – For multiple reasons, a saliva sample should be chosen over the more common urine sample to test for drugs present in the system.<sup class="reference">[42]</sup><sup class="reference">[43]</sup> Unlike urine, saliva tests cannot be adulterated, it can be administered rapidly, it has the ability to test for many things, it shows the metabolite drug and is cost-effective in the long run.<sup class="reference">[44]</sup> Some healthcare systems may consider cost an issue, but saliva tests are billed to the same code. <span style="color: #ff0000">[citation needed]</span><br/> ''Contact'': John Cribbs (john@nodrugsneeded.com)<br/> <br/> '''DEA Diversion Control Program (DCP)''' - This program is responsible for regulating and controlling more than 1.6 million DEA registrants involved in manufacturing, distributing, prescribing, and dispensing controlled prescription drugs (CPDs). DEA’s Diversion Control efforts are geared toward preventing the non-medical use of CPDs by providing education and training within the pharmaceutical and medical communities and pursuing those practitioners who are operating outside of reasonable medical standards. <sup class="reference">[45]</sup><br/> <br/> '''[https://labtestsonline.org/understanding/analytes/pharmacogenetic-tests/ Pharmacogenetics Test]''' -At $350 per test and only needed once in your life, this is a cost effective approach to ensure that patients receive an appropriate dose of pain medication.<sup class="reference">[46]</sup><br/> ''Contact'': John Cribbs (john@nodrugsneeded.com)<br/> <br/> '''[https://www.shatterproof.org/advocacy/state-by-state-information/prescriber-education Prescriber Education] -''' Physicians who prescribe opioid painkillers should receive training on the risks of overusing immediate release, extended-release, and long-acting formulations of pain medications. This training should be tied to the recently released ''CDC Guideline for Prescribing Opioids for Chronic Pain''.<sup class="reference">[47]</sup>
 = General Best Practices =
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 #[https://www.shatterproof.org/advocacy/federal-initiatives/prescription-drug-monitoring-programs [41]]
 #[http://catalyst.nejm.org/act-now-prescription-opioid-crisis/?utm_campaign=tw&utm_source=hs_email&utm_medium=email&utm_content=51100063&_hsenc=p2ANqtz-_oQWJ7-DxzFgvqArz6FRbZcZ6IGV9pybacNCcFzbO79WW05_bglhgesjejwFT992hRSFxknyMnqcTkzXYbtEhFGfokyDf4jl773soGbB7y_VGsB1k&_hsmi=51100063 [42]]
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-<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">__NOTOC__ <div class="mw-parser-output"><div class="mw-parser-output"><div class="wiki" id="content_view" style="display: block">
+<div class="mw-parser-output">Return to the [[Opioid_Top-Level_Strategy_Map|Opioid_Top-Level_Strategy_Map]] or&nbsp;[[ZOOM_MAP_-_Reduce_Prescription_of_Opioids|Zoom Map (Reduce Prescription of Opioids)&nbsp;]]&nbsp;or the [[ZOOM_MAP_-_Reduce_Access_to_Opioids|Zoom Map (Reduce Access to Opioids)]]
-Return to the [[Opioid_Top-Level_Strategy_Map|Opioid_Top-Level_Strategy_Map]] or&nbsp;[[ZOOM_MAP_-_Reduce_Prescription_of_Opioids|Zoom Map (Reduce Prescription of Opioids)&nbsp;]]&nbsp;or the [[ZOOM_MAP_-_Reduce_Access_to_Opioids|Zoom Map (Reduce Access to Opioids)]] __TOC__
+Reducing prescription of opioids contributes to reducing risk in multiple ways. First, it reduces the number of people who are beginning to use prescription opioids for legitimate prescribed reasons but who may begin to develop a dependence on opioids or a strong desire to keep using them when the specific medical need ends. Second, reducing the prescription of opioids will reduce the number of excess pills that are often diverted for inappropriate use.
-= Evidence =
+__TOC__
-<div class="_">States that have cracked down on doctors and pain clinics have seen in a decline in prescriptions and opioid-related deaths.<sup class="reference">[1]</sup></div> <div class="_">&nbsp;</div>
-= History =
+= Background =
 '''OxyContin'''<br/> The rate of pain reported by Americans has not changed much over time, and yet the number of painkiller prescriptions has increased 300 percent since 1999.<sup class="reference">[2]</sup> At the same time, the number of deaths due to prescription opioid overdoses has quadrupled.<sup class="reference">[3]</sup> The rise in availability of prescription opioids began with the prescription of OxyContin. OxyContin (oxycodone) was released by Purdue Pharmaceuticals in 1996 and marketed as having a lower abuse potential then other narcotics.<sup class="reference">[4]</sup> This enticed physicians to prescribe the oxycodone-based narcotic for common conditions, such as back aches and knee pain, in addition to the original intended recipients, cancer patients and the terminally ill. By 2010, 1 in every 5 pain related doctor's visits in the United States resulted in a narcotic prescription. Individuals discovered snorting or injecting the powder from crushed OxyContin tablets produces a high similar to heroin and "by 2000, parts of the United States, particularly rural areas, began to see skyrocketing rates of addiction and crime related to use of the drug."<sup class="reference">[5]</sup> Purdue Pharmaceuticals knew the drug had a high potential for abuse, but continued to market it as a time-released drug with low risk of abuse. In 2007, Purdue Pharma plead guilty in federal court to criminal charges for misleading doctors and patients and paid out over $600 million in fines.<sup class="reference">[6]</sup><br/> <br/> "For years the sole focus was on reducing non-medical use, reducing abuse," Dr. Andrew Kolodny, co-founder of Physicians for Responsible Opioid Prescribing. "They were trying to stop kids from getting into grandma's medicine cabinet. Nobody was asking why does every grandma now have opioids in her medicine cabinet." - Searching for Relief: the Opioid Epidemic in the United States.<sup class="reference">[7]</sup><br/> &nbsp;
-= Useful Statistics =
+== Useful Statistics ==
 *Surgery-related overprescribing results in 3.3 billion unused pills available for misuse<sup class="reference">[8]</sup>
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 #[https://www.shatterproof.org/advocacy/federal-initiatives/prescription-drug-monitoring-programs [41]]
 #[http://catalyst.nejm.org/act-now-prescription-opioid-crisis/?utm_campaign=tw&utm_source=hs_email&utm_medium=email&utm_content=51100063&_hsenc=p2ANqtz-_oQWJ7-DxzFgvqArz6FRbZcZ6IGV9pybacNCcFzbO79WW05_bglhgesjejwFT992hRSFxknyMnqcTkzXYbtEhFGfokyDf4jl773soGbB7y_VGsB1k&_hsmi=51100063 [42]]
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