CDC Plans Study Of Prescription Drug Monitoring Programs Next Year
The Centers for Disease Control and Prevention will undertake a study in 2008 on both prescription drug misuse fatality rates and prescription drug monitoring programs, CDC Medical Epidemiology Len Paulozzi said Oct. 24.
Discussing "drug poisoning involving prescription drugs in the U.S. as a public health problem," Paulozzi said that unintentional deaths from prescription drug abuse are the second leading cause of accidental deaths in the U.S. There were approximately 20,000 poisoning deaths in 2004, and "95 percent of these poisoning deaths are drug overdoses" and there is an "upward trending line" in this area.
In addition to its general surveillance activities, CDC will "focus on a study of prescription drug deaths [and] poisoning victims," and work with state health officials to "look at state-specific policy responses to this problem," he said.
Paulozzi, who is with CDC's National Center for Injury Prevention and Control, spoke at a hearing of the House Energy and Commerce Committee's Subcommittee on Oversight.
The hearing focused on the National All Schedules Prescription Electronic Reporting Act, a program to fund state efforts to prevent drug diversion and "doctor shopping" by prescription drug abusers by enhancing the interoperability of state drug monitoring programs and adding all Drug Enforcement Administration scheduled drugs - generally narcotics and other drugs subject to abuse - to monitoring efforts.
NASPER has yet to be implemented and subcommittee Chairman Bart Stupak, D-Mich., pins much of the blame on the Office of Management and Budget for not allocating funding (1"The Pink Sheet" Oct. 22, 2007, p. 32).
The subcommittee met privately with OMB Director Jim Nussle on Oct. 25 to discuss NASPER funding. A committee staffer said the meeting was cordial but Nussle made no commitments about the program.
According to an HHS Substance Abuse and Mental Health Services Administration study of current state-controlled substances monitoring programs, a federal survey conducted in 2005 found that "an estimated 15.2 million persons aged 12 or older (6.2 percent of all persons in that age group) used prescription-type psychotherapeutic drugs non-medically in the past 12 months. In 2005, there were 6.4 million (2.6 percent) persons aged 12 or older who used prescription-type psychotherapeutic drugs non-medically in the past month."
Of these, "4.7 million used pain relievers, 1.8 million used tranquilizers, 1.1 million used stimulants (including 512,000 methamphetamine users), and 272,000 used sedatives."
Presenting some 2006 data at the hearing, SAMSHA Director H. Westley Clark said that about 56 percent of non-medical users of prescription pain relievers obtained the products without charge from a friend or relative, about 20 percent from a single doctor, 15 percent from a friend or relative who sold them, 4 percent from a drug dealer, and 1.6 percent from multiple physicians.
During the hearing, Stupak had a testy exchange with Clark about the report, which the panel only received on the eve of the hearing. The study "was supposed to be done six months after the NASPER bill was signed into law which would have been August of 2005," Stupak complained.
Clark responded that the study required extensive "deliberations." Nonetheless, the report says that parts of SAMSHA's assessment are "inconclusive." For example, more study is needed to determine monitoring programs' "true impact" on "physicians' willingness to prescribe and patients' ability to access pharmacologic treatments."
Stupak also unsuccessfully pressed Clark for information on whether SAMSHA has been requesting money through NASPER's authorizations.
American Society for Interventional Pain Physicians President Andrea Trescot said that the number of Americans abusing controlled substance drugs has jumped from 6.2 million to 15.2 million in the last decade and that 75 percent to 90 percent of drug abusers have attained their medications legally. "We feel strongly that NASPER is a major weapon against prescription drug abuse and one of the most important features of NASPER is the information sharing across state lines," she said.
The hearing did not include witnesses from the drug industry, drug stores, or law enforcement.
- Anthony Vecchione
This article is reprinted from "The Pink Sheet" – October 29, 2007
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