Simple steps can help curb opiate misuse in doctor’s offices, study shows

Researchers from the University of Michigan and Ohio State University have come up with some simple steps to help doctor’s offices reduce the abuse of Oxycontin and other painkillers and help those that that may need substance abuse treatment. The study was conducted in a busy multi-physician clinic at Ohio State University that was resident-staffed and faculty-supervised.

Because it is difficult to predict who will abuse or misuse opioids, the policy the researchers came up with was applied to all patients receiving opioid prescriptions at the clinic. Four steps were taken:

  1. Create a registry of all patients receiving opioid prescriptions, along with their prescribing clinic physicians.
  2. Using Ohio’s online prescription database, monitor whether or not patients were “doctor shopping” in an attempt to get the same drug from many providers.
  3. Require patients and doctors to sign a mandatory agreement that listed the monitoring steps to be taken for clinic patients requesting opioids and the consequences if certain conditions or behaviors came about.
  4. Conduct annual and random urine screening for all patients requiring opioids for non-cancer pain to check for illicit drugs or other prescriptions that could interact dangerously with the prescribed opioid.

In all, the study revealed that 35% of the 167 patients in the clinic’s opioid registry violated the new policy in some way. Patients who were receiving Oxycontin or another medicine that contained its active ingredient, oxycodone, were twice as likely as other opioid registry patients to violate the clinic policy. Most violations were due to failed drug tests that showed illegal drug use or getting prescriptions from multiple physicians. Those that showed dependence or abuse were referred for treatment.

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