Prescription drug misuse has reached epidemic proportions in the United States. Given the magnitude of the problem, strategies to prevent initiation of prescription opioid misuse, treat existing opioid use disorders, and prevent overdose are of utmost importance. This article will summarize such strategies, including improved prescriber education, prescription drug monitoring programs, medication take-back programs, controlled substance lock-in programs, and community-based naloxone distribution.
Substance Abuse and Mental Health Services Administration. Results From the 2013 National Survey on Drug Use and Health: Summary of National Findings. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2014. NSDUH Series H-46, HHS Publication No. (SMA) 14-4863. http://www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdf. Accessed June 23, 2015.
2.
ChenLHHedegaardHWarnerM. Drug-Poisoning Deaths Involving Opioid Analgesics: United States, 1999-2011. Hyattsville, MD: National Center for Health Statistics; 2014. NCHS Data Brief No 166.
3.
American Pharmacists Association. Pharmacist’s role in addressing opioid abuse, addiction, and diversion. J Am Pharm Assoc. 2014;54:e5-e15.
4.
JohnstonLDO’MalleyPMBachmanJG. Monitoring the Future: National Survey Results on Drug Use, Overview of Key Findings 2010. Bethesda, MD: MIDA, NIH, DHHS; 2010.
ChouRTurnerJADevineEB. The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health pathways to prevention workshop. Ann Intern Med. 2015;162:276-286.
7.
LeeMSilvermanSMHansenH. A comprehensive review of opioid-induced hyperalgesia. Pain Physician. 2011;14:145-161.
8.
BrushDE. Complications of long-term opioid therapy for management of chronic pain: the paradox of opioid-induced hyperalgesia. J Med Toxicol. 2012;8:387-392.
9.
ComptonWMBoyleMWargoE. Prescription opioid abuse: problems and responses. Prev Med. 2015;80:5-9.
10.
BradyJEWunschHDiMaggioC. Prescription drug monitoring and dispensing of prescription opioids. Public Health Rep. 2014;129:139-147.
11.
BaehrenDFMarcoCADrozDE. A statewide prescription drug monitoring program affects emergency department prescribing behaviors. Ann Emerg Med. 2010;56:19-23.
12.
US General Accounting Office. Report to the subcommittee on oversight and investigations, committee on energy and commerce, House of Representatives. Prescription drugs: state monitoring programs provide useful tool to reduce diversion. http://www.gao.gov/new.items/d02634.pdf. Accessed July 26, 2015.
13.
GriggsCAWeinerSGFeldmanJA. Prescription drug monitoring programs: examining limitations and future approaches. West J Emerg Med. 2015;16:67-70.
14.
StewartHMalinowshiAOchsL. Inside Maine’s medicine cabinet: findings from the drug enforcement administration’s medication take-back events. Am J Public Health. 2015;105:e65-e71.
15.
BlakeSGFeldhausJFHunterTS. PMD2 the effect of Louisiana Medicaid lock-in on prescription drug utilization and expenditures. Value Health. 1998;1:72.
16.
MitchellL. Pharmacy lock-in program promotes appropriate use of resources. J Okla State Med Assoc. 2009;102:276.
17.
Centers for Disease Control and Prevention. Vital Signs: Overdoses of Prescription Opioid Pain Relievers: United States, 1999-2008. Morb Mortal Wkly Rep. 2011;60:1487-1492.
18.
JonesJDRouxPStancliffS. Brief overdose education can significantly increase accurate recognition of opioid overdose among heroin users. Int J Drug Policy. 2014;25:166-170.
19.
HewlettLWermelingDP. Survey of naloxone legal status in opioid overdose prevention and treatment. J Opioid Manag. 2013;9:369-377.
20.
ClarkAKWilderCMWinstanleyEL. A systematic review of community opioid overdose prevention and naloxone distribution programs. J Addict Med. 2014;8:153-163.
21.
WalleyAYXuanZHackmanHH. Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts: interrupted time series analysis. BMJ. 2013;346:f174.
22.
RandoJBroeringDOlsonJE. Intranasal naloxone administration by police first responders is associated with decreased opioid overdose deaths. Am J Emerg Med 2015, http://dx.doi.org/10.1016/j.ajem.2015.05.022