Working Together: The Only Approach to Prescription Abuse | Commentary
Prescription drug abuse is a pervasive public health problem that transcends age and ZIP code. No one sets out to be an addict and every person has a unique story — a grandmother with chronic pain who slowly and unwittingly becomes dependent on her medication, the teenager who steals from a parent’s medicine cabinet and misuses or even sells their medicines, or the war veteran who simply seeks to overcome incomprehensible pain that never stops.
More than 6 million Americans misuse and abuse prescription drugs every year, and pain relievers are frequently the drug of choice. The Centers for Disease Control and Prevention has labeled prescription drug abuse a “growing, deadly epidemic” that claims the lives of 105 Americans every day, with another 6,748 treated in emergency rooms for their misuse or abuse. Since 1999, the CDC has seen a 400 percent increase in prescription drug overdoses among women in particular. These trends are alarming, unsustainable and are ravaging our communities.
To stubbornly double down on existing strategies that have not effectively curbed the problem will only worsen the crisis. There is no one type of abuser or misuser, and there is no one solution. It is not an issue that exists somewhere else, to be dealt with by somebody else. It is a problem that is here and now, and can only be addressed effectively if we work together.
More than 100 million American adults suffer with chronic or short-term pain — nearly a third of the population. It is important to recognize these patients rely on medically necessary, often life-saving medicines and that the vast majority of those patients use pain medications as prescribed. Any solution to prescription drug abuse must ensure these patients can access the medications they need to lead a more productive life.
To ensure access while addressing the public health crisis, a group of industry stakeholders joined together more than a year ago as leaders in the prescription drug supply chain to form the Alliance to Prevent the Abuse of Medicines. Our members are among the world’s largest manufacturers, distributors, pharmacy benefit managers, pharmacies, medical societies, testing laboratories and overdose treatment providers. The alliance brings a comprehensive perspective that seeks to overcome previous approaches that were disparate and often limited, yielding only mixed results. While the laws against the trafficking and abuse of controlled substances must be enforced to their fullest extent, we believe a narrow strategy that focuses solely on arrests and prosecutions virtually guarantees the status quo, or worse.
Instead, we must view this issue through a public health lens and attack the problem where diversion is occurring, and determine how best to prevent it.
The alliance’s public health focused approach features four umbrella principles — patient and prescriber education, appropriate drug storage and disposal, prescription drug monitoring programs, and robust patient treatment — and requires a commitment by all stakeholders working together to do their part. Better educating prescribers, pharmacists and patients regarding the issue of prescription drug abuse will help achieve early prevention and identification of such abuse, and thwart misuse at the point of diversion. Ensuring more safe and effective ways for lawful users to dispose of unused medicines will limit opportunities for medicines to fall into the wrong hands. And for those who struggle with misuse and abuse of prescription medicines, we must improve detection and strategies for treating addiction.
In our view, the most effective means for prevention and early identification is through the deployment of state-based prescription drug monitoring programs. PDMPs allow prescribers to access frequently updated patient information to determine whether the patient is participating in “doctor shopping” or otherwise seeking to abuse controlled substances. These programs exist in 49 states, and have shown to be highly effective when equipped with the requisite resources and configured to allow providers access to the information at the point of care, in their ordinary workflow. The alliance believes that a robust, 50-state PDMP system would be a significant step toward curbing abuse.
The misuse of prescription drugs is not a red or blue issue, or a rich or poor issue; it is an “everyone” issue. It is a problem that will continue to grow until it is addressed comprehensively and effectively. To this end, the alliance has partnered with the U.S. Chamber of Commerce and CQ Roll Call to host a bipartisan summit Monday to discuss solutions to prescription drug abuse, featuring keynote speakers Govs. Charlie Baker, R-Mass., and Terry McAuliffe, D-Va., with Sens. Rob Portman, R-Ohio, and Sheldon Whitehouse, D-R.I.
The alliance has invited and continues to welcome all stakeholders who share our goals — including federal and state policymakers — to join us. Our hope is that by working together we can help restore the public health.
Danielle Hagen is the spokeswoman for the Alliance to Prevent the Abuse of Medicines, which is comprised of the American Medical Association, Cardinal Health, CVS Health, the Healthcare Distribution Management Association, Kaléo Pharma, Millennium Health, Prime Therapeutics and Teva Pharmaceuticals.