Doctors' Approach to Monitoring Opioid Use is Lax, Study Finds
A new study from Albert Einstein College of Medicine of Yeshiva University has found that despite the potential for prescription drug abuse, addiction, and overdose, many primary care physicians don’t pay adequate attention to patients taking prescription opioid drugs (such as Vicodin and OxyContin).
The study found that doctors were lax in monitoring patients at a high risk for opioid abuse, such as those with a history of drug abuse or addiction. According to the National Institute on Drug Abuse, prescription drug abuse now ranks second after marijuana for illicit drugs, with about 2.2. million Americans abusing prescription drugs for the first time in 2009.
An estimated 48 million people over the age of 12 have abused prescription drugs in their lifetime, according to a 2004 NIDA report. The report also showed that opioids were the most commonly abused prescription drugs.
Lead author Joanna Starrels, M.D., M.S., assistant professor of medicine at Albert Einstein College of Medicine, said that the findings should be a call for a standardized approach to monitoring opioid drug prescriptions.
For the study, the researchers examined records of more than 1,600 primary care patients for an average of two years while taking prescription opioids for chronic non-cancer pain. They looked at whether patients were drug tested, were seen regularly in the office, or received multiple early opioid refills.
Only 8 percent of patients had undergone urine drug testing. Although this test was more common in patients at a high risk for opioid abuse, the rate of testing among these patients was still low at 24 percent. Only half of the patients were seen regularly in the office, and those at a higher risk of opioid abuse were not seen more often than other patients.
Although only about 23 percent of all patients received two or more early opioid refills, those at a greater risk for opioid abuse were more likely to be given multiple early refills.
Dr. Starrels said this was disturbing, and that they hope the findings will call attention to the issue. She added that while most primary care physicians are aware of these problems, there aren’t sufficient strategies in place to help reduce the risks of opioid abuse and dependence.
The researchers recommend that physicians standardize a treatment plan for all patients taking opioid drugs for a long period of time (including drug testing), schedule regular office visits to evaluate the patients’ response to the drugs and any signs of abuse, and create and maintain a refill schedule to prevent early refills.
Source: Science Daily, Doctors Lax in Monitoring Potentially Addicting Drugs, Study Suggests, March 3, 2011