ISSUE: PRESCRIPTION DRUG ABUSE
STATEMENT: Nationally, deaths involving opioids have more than quadrupled since 1999. The sharp rise in opioid overdose deaths closely parallels an equally sharp increase in the prescribing of these drugs. Opioid pain reliever sales in the United States quadrupled from 1999 to 2010. Similarly, the substance abuse treatment admission rate for opioid abuse in 2010 was seven times higher than in 1999. Significantly, Indiana’s overdose death rate for 2010 (14.4 per 100,000 population) is above the national rate (12.4 per 100,000 population). Every ef-fort must be made to prevent the inappropriate prescribing which leads to Opioid Use Dis-order. These efforts should include:
- Requiring prescribers to take continuing education courses on proper prescribing practices of opioids and the risk of dependency and addiction. Indiana is one of a handful of states which does not require continuing education as part of its medical licensing requirements;
- Requiring prescribers to discuss with their patients the addictive potential of opioids before prescribing. Sometimes called ‘Right to Know,’ practitioners would note in the medical record that the patient has discussed with the practitioner the risks of controlled substances and available alternative treatments;
- Requiring all persons with a Controlled Substance Registration (CSR) to register with INSPECT prior to their CSR renewal. Currently only about 40% of all SCR holders are registered with INSPECT.
- Require prescribers to query INSPECT every time they prescribe a controlled sub-stance. In at least one other state, mandatory checks have resulted in a reduction of opioids prescribed (12-36%), a reduction in overdose hospitalizations (26%), and a reduction in prescription opioid deaths (25%).
- Require prescribers to be notified of patient overdoses.
- Create a peer review committee within INSPECT to review prescribing and dis-pensing data to identify prescribers who are working outside established profes-sional standards for referral to the IPLA.
- Requiring Indiana licensing of Office Based Opiate Treatment facilities to ensure appropriate prescribing and evidence based treatment practice protocols.
MHAI will work to ensure appropriate evidence based prescribing of prescription opioid medications.
PRIORITY LEVEL: I