Drug poisoning deemed leading cause of death and injury in US. Do we blame physicians, pharmacies or ‘doc shoppers’?

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The American Journal of Preventive Medicine published a recent study indicating a sharp increase in death and/or injury attributed to drug poisoning. The study, which was the first of its kind to be conducted on a county-level, revealed that death by drug poisoning, majorly induced by legal prescription and illegal street drugs, increased by more than 300 percent over the past 3 decades in urban and rural areas alike. The most surprising fact was that the majority of those drug overdose deaths were a result of ingesting prescription drugs. So, the question arises—who is to blame?

Large pharmacy chains, such as CVS Caremark, point their fingers at “prescription-happy” doctors. In August of 2013, CVS announced that it would no longer honor prescriptions from doctors and other healthcare providers that were noted as prescribing painkillers at unusually high rates. CVS Caremark identified over 36 healthcare professionals with “extreme patterns of prescribing high-risk drugs” by checking their prescription rates against those of healthcare providers in similar specialties and geographic regions with patients of comparable demographics.

The United States government is looking for solutions to the country-wide drug poisoning epidemic on the federal and state levels. The Drug Enforcement Administration (DEA) is cracking down on pharmacy chains, as it believes these companies are major contributors to the wide-spread abuse, misuse, and overdose of prescription high-risk drugs. Consequently, the push for CVS Caremark’s prescription policy change was a result of such pressure from government authorities.

Newsday published an article in September 2013, documenting the success of New York State’s new online system for tracking prescription pill abuse. The system looks for doctor shopping, a practice described as “when patients visit a number of doctors in search of prescriptions for pain pills.” The state-wide system, known as Internet System for Tracking Over-Prescribing or I-STOP, detected over 200 cases of pill abuse in New York within the first three days of the system’s implementation.

In coordination with New York State’s new prescription drug abuse tracking system, NY law now requires real-time reporting to the I-STOP system by pharmacists upon filling opioid prescriptions. New York is also breaking ground as the first state to legally require physicians to consult patients on their prescription histories before prescribing them opioid drugs in hopes of stopping doctor shoppers in their tracks.

It seems as though over-prescribing healthcare providers, pharmacies, and doctor shoppers are all contributors to the overall issue of increased death and injury by drug poisoning in the US. We can only hope that further systems and legislation will be put in place to slow the prescription overdose epidemic.