scholarly journals Doctor Shopping Reveals Geographical Variations in Opioid Abuse

2013 ◽  
Vol 1;16 (1;1) ◽  
pp. 89-100
Author(s):  
Joëlle Micallef
Keyword(s):  
Drug Abuse ◽  
Prescription Drug ◽  
Severe Pain ◽  
Oral Morphine ◽  
Opioid Abuse ◽  
Prescription Opioid ◽  
Moderate Pain ◽  
Doctor Shopping ◽  
Geographical Variations ◽  
Reimbursement Database

Background: Prescription opioid abuse is not homogeneous due to varying patterns of use and different geographic preferences. Because doctor shopping is one of the main sources of diversion, it has previously been used to estimate drug abuse. Objectives: The aim of this study was to describe and compare opioid abuse in 2008 using doctor shopping to estimate abuse in 3 French regions. Setting: Data for this study came from the General Health Insurance (GHI) reimbursement database, which covers 77% of the French population. All individuals living in ProvenceAlpes-Côte d’Azur-Corse (PACA), Rhône-Alpes (RA), or Midi-Pyrénées (MP) that received at least one reimbursement for oral opioids from the GHI in 2008 were included. Methods: Oral opioids under study were opioids for mild to moderate pain (dextropropoxyphene, codeine, tramadol, dihydrocodeine), opoids for moderately severe to severe pain (oral morphine, oxycodone, buprenorphine painkiller, hydromorphone), and opioid maintenance treatments (buprenorphine maintenance, methadone). For a given opioid, the Doctor Shopping Quantity (DSQ) is the quantity obtained by overlapping prescriptions from several prescribers. It is used to estimate the magnitude of abuse. The Doctor Shopping Indicator (DSI) is the DSQ divided by the total dispensed quantity. It is used to estimate the abuse corrected for use. Results: The total DSQ for opioids in PACA (213.3 DDD/1,000 inhabitants) was twofold superior to that in RA (115.1 DDD/1,000) and in MP (106.2 DDD/1,000). The DSQ of opioids for mild to moderate pain was 75.5DDD/1000 (DSI=1.1%), 19.7DDD/1,000 (DSI=5.0%) for opioids for moderately severe to severe pain, and 55.3DDD/1,000 (DSI=6.2%) for opioid maintenance treatments. Emergent signals of abuse have been observed at a regional level for oxycodone in MP and dihydrocodeine in RA and MP. Limitations: The main limitation of this study is that the GHI reimbursement database provides information about dispensed and reimbursed prescription drugs, and not necessarily the actual quantity used. Conclusion: These results confirm important variations in the 3 French regions despite them being geographically close. Besides, they highlight different rates of opioid abuse between opioids for mild to moderate pain, opioids for moderately severe to severe pain, and opioid maintenance treatments, as well as differences within these groups. Key words: Prescription drug abuse, Opioid abuse, Prescription opioid analgesics, opioids for mild to moderate pain , Opioids for moderately severe to severe pain, Opioid maintenance treatments, Prescription drug database, Doctor shopping

scholarly journals Prescription Opioid Usage and Abuse Relationships: An Evaluation of State Prescription Drug Monitoring Program Efficacy

2009 ◽  
Vol 3 ◽  
pp. SART.S2345 ◽  
Author(s):  
Richard M. Reisman ◽  
Pareen J. Shenoy ◽  
Adam J. Atherly ◽  
Christopher R. Flowers
Keyword(s):  
Drug Abuse ◽  
Prescription Drug ◽  
Drug Monitoring ◽  
Monitoring Program ◽  
Opioid Abuse ◽  
Prescription Opioid ◽  
Control Group ◽  
Prescription Opioids ◽  
Data Set ◽  
Prescription Opioid Abuse

Context The dramatic rise in the use of prescription opioids to treat non-cancer pain has been paralleled by increasing prescription opioid abuse. However, detailed analyses of these trends and programs to address them are lacking. Objective To study the association between state shipments of prescription opioids for medical use and prescription opioid abuse admissions and to assess the effects of state prescription drug monitoring programs (PDMPs) on prescription opioid abuse admissions. Design and Setting A retrospective ecological cohort study comparing state prescription opioid shipments (source: Automation of Reports and Consolidated Orders Systems database) and inpatient admissions for prescription opioid abuse (source: Treatment Episode Data Set) in 14 states with PDMPs (intervention group) and 36 states without PDMPs (control group) for the period 1997–2003. Results From 1997 to 2003, oxycodone, morphine, and hydrocodone shipments increased by 479%, 100%, and 148% respectively. Increasing prescription oxycodone shipments were significantly associated with increasing prescription opioid admission rates (p < 0.001). PDMP states had significantly lower oxycodone shipments than the control group. PDMP states had less increase in prescription opioid admissions per year (p = 0.063). A patient admitted to an inpatient drug abuse rehabilitation program in a PDMP state was less likely to be admitted for prescription opioid drug abuse (Odds ratio = 0.775, 95% Confidence Interval 0.764–0.785). Conclusions PDMPs appear to decrease the quantity of oxycodone shipments and the prescription opioid admission rate for states with these programs. Overall, opioid shipments rose significantly in PDMP states during the study period indicating a negligible “chilling effect” on physician prescribing.

Prescription opioid abuse among drug-involved street-based sex workers

2006 ◽  
Vol 2 (5) ◽  
pp. 283 ◽  
Author(s):  
Hilary L. Surratt, PhD ◽  
James A. Inciardi, PhD ◽  
Steven P.q Kurtz, PhD
Keyword(s):  
Drug Abuse ◽  
Prescription Drug ◽  
Sex Workers ◽  
Opioid Abuse ◽  
Prescription Drug Abuse ◽  
Prescription Opioid ◽  
Prescription Opioids ◽  
Hiv Intervention ◽  
The Past ◽  
Prescription Opioid Abuse

National population surveys and individual studies over the past decade have documented the escalating abuse of a variety of prescription medications, particularly prescription opioids. Although surveillance data provide important information for estimating the prevalence of prescription opioid abuse in the general population, studies documenting the patterns of prescription drug abuse among chronic street-drug-using populations are extremely rare. This paper examines the abuse of prescription opioids among drug-involved street-based sex workers in Miami, Florida. The data for this study were drawn from an ongoing HIV intervention trial initiated in 2001, designed to test the relative effectiveness of two alternative HIV prevention protocols for this population. Participants in the study were recruited through traditional targeted sampling strategies, and complete data are available on 588 street-based sex workers. In terms of prescription drug abuse, 12.2 percent of the sample reported using at least one opioid analgesic in the past 90 days without having a legitimate prescription. Logistic regression analyses were conducted to examine the associations between prescription opioid abuse and its predictors. In the multivariate model, factors positively associated with prescription opioid abuse included: Caucasian race (OR = 2.53; 95 percent CI 1.30 to 4.91), current powder cocaine use (OR = 2.28; 95 percent CI 1.28 to 4.08), current heroin use (OR = 2.08; 95 percent CI 1.10 to 3.92), 90-day physical abuse/victimization (OR = 2.07; 95 percent CI 1.18 to 3.61), and shorter sex-work involvement (OR = 1.98; 95 percent CI 1.13 to 3.48). In contrast, daily crack smoking was negatively associated with prescription opioid abuse (OR = 0.61; 95 percent CI 0.33 to 1.10). This study provides some of the first empirical evidence to indicate that prescription opioid abuse is emerging in a heretofore unstudied community of marginalized drug-using sex workers. In addition, data on this population’s mechanisms of access to prescription opioids clearly suggest that there is an active black market for these drugs. These findings warrant intensive study to determine the relative contribution of each mechanism of diversion to the illicit market.

A Review on Prescription Drug Monitoring Program

2021 ◽  
pp. 265-268
Author(s):  
Someshwar D. Mankar ◽  
Abhijit S. Navale ◽  
Suraj R. Kadam
Keyword(s):  
Systematic Review ◽  
Prescription Drug ◽  
Drug Monitoring ◽  
Monitoring Program ◽  
Opioid Abuse ◽  
Prescription Opioid ◽  
Prescription Drug Monitoring Program ◽  
Prescription Opioid Abuse

Nowadays Prescription Opioid Abuse has become a serious problem, to monitor and reduce Opioid Abuse most of countries developed Prescription Drug Monitoring Program (PDMP). Regarding to this we conduct a systematic review to understanding the PDMP impact in order to reduce Opioid Abuse and improving prescriber practices. This review can help to guide efforts to better response to the Opioid crises.

scholarly journals Early Detection of Prescription Drug Abuse Using Doctor Shopping Monitoring From Claims Databases: Illustration From the Experience of the French Addictovigilance Network

2021 ◽  
Vol 12 ◽  
Author(s):  
Thomas Soeiro ◽  
Clémence Lacroix ◽  
Vincent Pradel ◽  
Maryse Lapeyre-Mestre ◽  
Joëlle Micallef
Keyword(s):  
Drug Abuse ◽  
Early Detection ◽  
Prescription Drug ◽  
Prescription Drugs ◽  
Best Practice ◽  
Illicit Drugs ◽  
Opioid Analgesics ◽  
Outcome Data ◽  
Prescription Drug Abuse ◽  
Doctor Shopping

Opioid analgesics and maintenance treatments, benzodiazepines and z-drugs, and other sedatives and stimulants are increasingly being abused to induce psychoactive effects or alter the effects of other drugs, eventually leading to dependence. Awareness of prescription drug abuse has been increasing in the last two decades, and organizations such as the International Narcotics Control Board has predicted that, worldwide, prescription drug abuse may exceed the use of illicit drugs. Assessment of prescription drug abuse tackles an issue that is hidden by nature, which therefore requires a specific monitoring. The current best practice is to use multiple detection systems to assess prescription drug abuse by various populations in a timely, sensitive, and specific manner. In the early 2000's, we designed a method to detect and quantify doctor shopping for prescription drugs from the French National Health Data System, which is one of the world's largest claims database, and a first-class data source for pharmacoepidemiological studies. Doctor shopping is a well-known behavior that involves overlapping prescriptions from multiple prescribers for the same drug, to obtain higher doses than those prescribed by each prescriber on an individual basis. In addition, doctor shopping may play an important role in supplying the black market. The paper aims to review how doctor shopping monitoring can improve the early detection of prescription drug abuse within a multidimensional monitoring. The paper provides an in-depth overview of two decades of development and validation of the method as a complementary component of the multidimensional monitoring conducted by the French Addictovigilance Network. The process accounted for the relevant determinants of prescription drug abuse, such as pharmacological data (e.g., formulations and doses), chronological and geographical data (e.g., impact of measures and comparison between regions), and epidemiological and outcome data (e.g., profiles of patients and trajectories of care) for several pharmacological classes (e.g., opioids, benzodiazepines, antidepressants, and methylphenidate).

Slow-Release Oral Morphine Sulfate Abuse: Results of the Postmarketing Surveillance Systems for Psychoactive Prescription Drug Abuse in France

2013 ◽  
Vol 19 (5) ◽  
pp. 235-244 ◽  
Author(s):  
Hélène Peyriere ◽  
Céline Eiden ◽  
Joëlle Micallef ◽  
Maryse Lapeyre-Mestre ◽  
Jean-Luc Faillie ◽  
...  
Keyword(s):  
Drug Abuse ◽  
Prescription Drug ◽  
Slow Release ◽  
Oral Morphine ◽  
Morphine Sulfate ◽  
Prescription Drug Abuse ◽  
Surveillance Systems ◽  
Postmarketing Surveillance
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