CDC: Focus more on 'problem prescribers'

"Problem prescribers" play a more significant role in the prescription drug abuse epidemic than previously thought, according to a study published in JAMA Internal Medicine, which identified physicians as the top source of narcotic painkillers for chronic abusers.

Previous analysis of where abusers obtained their drugs did not separate casual users from chronic ones, an article in the Los Angeles Times explained. When research lumps both types of drug misuse together, friends and family rank as the most common source for the drugs as problem prescribers can obtain them for free. Thus, many abuse-prevention efforts, such as "take back" days encouraging community members to clean out home medicine cabinets, have so far focused on reducing drug diversion and theft.

But when researchers honed in on those who chronically misuse medications--defined as people who took pills at least 200 days in the past year--the highest percentage (27.3 percent) got the pills from their doctors. Friends and family were a close second at 26.4 percent.

Nonetheless, knowing where chronic users obtain medications is important because these individuals are far more likely overdose. "Every time you use the drug, it's another opportunity to overdose," study co-author Leonard J. Paulozzi, M.D., an overdose prevention specialist at the Centers for Disease Control and Prevention (CDC), which conducted the study, told the Times.

Authorities must do a better job of spotting inappropriate prescribing by using prescription drug monitoring programs (PDMP), Tom Frieden, M.D., director of the CDC, said in response to the findings.

"There is a coalescing recognition of what's going to be important," Frieden told the newspaper. "One is clearly going to be PDMPs--and PDMPs that are mandatory, real time and actively monitored so that the folks running them identify problem patients and problem doctors."

The Medical Board of California recently formed a committee to develop new guidelines for how doctors prescribe narcotic painkillers, according to the Times.

To learn more:
- here's the abstract
- read the Los Angeles Times article