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    To curb opioid abuse, new technologies must be embraced

    In October 2017, the Trump administration declared the opioid crisis a national public health emergency. While the impact of this declaration currently remains unclear due to the lack of serious funding, the severity of the problem is undeniable: 7.3 Americans die every hour from opioid overdoses and related causes, based on 2017 CDC data—a dramatic 52% increase from 3.8 per hour in 2015. Worse yet, this number is conservative as many opioid-related deaths are often attributed to other causes.


    RELATED READING: Why do we keep prescribing heroin to patients?


    Over the last several years, numerous states have responded to the crisis by mandating and implementing electronic prescription drug monitoring programs (PDMPs) and the electronic prescribing of controlled substances (EPCS). Currently, 11 states have either mandated EPCS or have pending legislation. Only one state (Missouri) has a PDMP that is being implemented county by county since its governor signed an executive order after the legislature failed to pass a bill.Dr. Sullivan

    EPCS reduces the opportunity for fraudulent prescriptions by increasing security, while PDMPs help prescribers to be well-informed about their patients’ prescribing histories, making it easier to identify “doctor shoppers.”

    These technologies hold great promise for helping physicians combat the opioid battle, but legislators and regulators must put more funding and positive incentives behind efforts to encourage their use. In addition, current complexities of registering to use these tools and integrating them into prescribers’ workflows need to be streamlined.

    Electronic Prescribing of Controlled Substances

    Enhanced security features within the U.S. Drug Enforcement Agency (DEA) EPCS rule reduce the fraud and abuse of controlled substance prescriptions. Prescribers can be authenticated and prescriptions can be transmitted to pharmacies securely without risk of alteration or diversion. With proper analytics, EPCS can also help clinical leaders of group practices confidentiality identify and talk to physicians who have prescribing practices that are very inconsistent with peer specialties.


    FURTHER INSIGHTS: A former opioid addict's story


    Even though only 11 states mandate the use of EPCS, all 50 states have authorized its use. Healthcare.gov reports that as of September 2016, 88% of pharmacies were accepting and processing EPCS, and that the rate of EPCS prescribing had grown 256% between 2015 to 2016. Despite the rapid adoption, only 20% of prescribers were enabled for EPCS and just 14% of all controlled substances were sent electronically to pharmacies.

    Next: One likely reason for the slow adoption of EPCS nationwide

    Tom Sullivan, MD
    Tom Sullivan, MD, is a board-certified cardiologist and internal medicine specialist with over 40 years of clinical practice. He is ...


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    • [email protected]
      The EPCS will NOT work in Georgia where pharmacists can refuse to fill prescriptions they don't like and, much too often, patients are unable to rely on a specific pharmacy to fill their prescriptions. Adding to the problem are insurance companies that have become the gate keepers of controlled substance Rx's, overriding the physician and imposing limits on quantity for pain specialists based on CDC "recommendations" for PCP's.
    • [email protected]
      Dr Sullivan, very noble and well stated. Really though, you advocate another burden for those of us in the trenches. If you would like to cover the cost of implementation and training, then maybe you have some traction. Why not prosecute the very few "bad prescribers", pull their license, fines, and even prison terms. The vast number of us are good stewards of our prescribing privileges, law abiding, and should not be hampered with more restrictions, debts, and threats. Go get the bad guys and leave the good guys alone please. You regulators are burning us out of primary care Dr Bob
    • Anonymous
      Hmmmmm.... The "chief strategy officer of e-prescribing and medication management solutions provider DrFirst" recommends we use (and pay for in $$ and time) e-prescribing to stop the opioid crisis? Imagine that. I'm sure his company can successfully contribute to state level politicians in a rent seeking move to require this.

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