White House writes a prescription for better drug abuse prevention

The Obama Administration announced new public and private sector efforts designed to address the country’s prescription drug abuse and heroin epidemic. The efforts include opioid provider training, prescription drug misuse education programs, and improved access to treatment for substance abuse disorders.

Epidemic

According to a White House fact sheet, “more Americans now die every year from drug overdoses than they do in motor vehicle crashes and the majority of those overdoses involve prescription medications.” The problem is in part related to opioid prescribing practice. In 2012 health care providers wrote 259 million prescriptions for opioid pain medications—hydrocodone, oxycodone, morphine, and methadone. In four out of five cases, heroin, which belongs to the same class of drugs, is used by individuals who started by misusing prescription medications. In light of some federal efforts to reduce prescription drug abuse, overdoses related to prescription medications are leveling off. However, between 2011 and 2013, heroin related overdoses nearly doubled.

Action

Proposed actions include: (1) opioid prescriber training of 540,000 health care provider by more than 40 provider groups, within the next two years; (2) doubling, from 30,000 to 60,000, the number of health physicians qualified to prescribe buprenorphine for opioid use disorder treatment, within three years; (3) doubling the number of physicians who can prescribe naloxone (a drug used to reverse an opioid overdose); (4) doubling the number of providers registered with their State Prescription Drug Monitoring Programs; and (5) reaching 4 million providers with “awareness messaging” regarding things like appropriate prescribing practices.

Medicare survey

HHS also plans to review how pain management is evaluated and effected by patient satisfaction surveys used by hospitals and other health care providers. U.S. Sen. Lamar Alexander (R-Tenn) praised the Obama Administration’s decision to look into the impact of such surveys based upon concerns “that the patient satisfaction survey for Medicare patients actually has the perverse effect of encouraging physicians to overprescribe painkilling opiates because reimbursements for hospitals are based to some extent upon the score that patients give doctors about how well they’re satisfied with their treatment.”

Support

The American Medical Association (AMA) has spoken out in favor of the drug abuse prevention initiatives. Specifically, the AMA has pledged to devote its efforts towards: (1) increasing physician registration and use of prescription drug monitoring programs; (2) improving physician education and training regarding safe prescribing practices; (3) increasing access to naloxone to help reduce deaths from overdose along with “strong Good Samaritan protections;” and (4) improving access to treatment for substance abuse disorders.