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Vital Signs: Variation Among States in Prescribing of Opioid Pain Relievers and Benzodiazepines — United States, 2012

July 3, 2014 Comments off

Vital Signs: Variation Among States in Prescribing of Opioid Pain Relievers and Benzodiazepines — United States, 2012
Source: Morbidity and Mortality Weekly Report (CDC)

Background:
Overprescribing of opioid pain relievers (OPR) can result in multiple adverse health outcomes, including fatal overdoses. Interstate variation in rates of prescribing OPR and other prescription drugs prone to abuse, such as benzodiazepines, might indicate areas where prescribing patterns need further evaluation.

Methods:
CDC analyzed a commercial database (IMS Health) to assess the potential for improved prescribing of OPR and other drugs. CDC calculated state rates and measures of variation for OPR, long-acting/extended-release (LA/ER) OPR, high-dose OPR, and benzodiazepines.
Results: In 2012, prescribers wrote 82.5 OPR and 37.6 benzodiazepine prescriptions per 100 persons in the United States. State rates varied 2.7-fold for OPR and 3.7-fold for benzodiazepines. For both OPR and benzodiazepines, rates were higher in the South census region, and three Southern states were two or more standard deviations above the mean. Rates for LA/ER and high-dose OPR were highest in the Northeast. Rates varied 22-fold for one type of OPR, oxymorphone.

Conclusions:
Factors accounting for the regional variation are unknown. Such wide variations are unlikely to be attributable to underlying differences in the health status of the population. High rates indicate the need to identify prescribing practices that might not appropriately balance pain relief and patient safety.

Implications for Public Health:
State policy makers might reduce the harms associated with abuse of prescription drugs by implementing changes that will make the prescribing of these drugs more cautious and more consistent with clinical recommendations.

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UN World Drug Report 2014

July 2, 2014 Comments off

World Drug Report 2014
Source: United Nations
From press release (PDF):

Drug use prevalence is stable around the world, according to the 2014 World Drug Report of the United Nations Office on Drugs and Crime (UNODC), with around 243 million individuals, or 5 per cent of the world’s population aged 15- 64 having used an illicit drug in 2012. Problem drug users meanwhile numbered about 27 million, roughly 0.6 per cent of the world’s adult population, or 1 in every 200 people.

Youth Risk Behavior Surveillance—United States, 2013

June 13, 2014 Comments off

Youth Risk Behavior Surveillance—United States, 2013 (PDF)
Source: Morbidity and Mortality Weekly Report (CDC)
From press release:

Cigarette smoking rates among high school students have dropped to the lowest levels since the National Youth Risk Behavior Survey (YRBS) began in 1991, according to the 2013 results released today by the Centers for Disease Control and Prevention.

By achieving a teen smoking rate of 15.7 percent, the United States has met its national Healthy People 2020External Web Site Icon objective of reducing adolescent cigarette use to 16 percent or less.

Despite this progress, reducing overall tobacco use remains a significant challenge. For example, other national surveys show increases in hookah and e-cigarette use. In the YRBS, no change in smokeless tobacco use was observed among adolescents since 1999, and the decline in cigar use has slowed in recent years, with cigar use now at 23 percent among male high school seniors.

CRS — Prescription Drug Abuse

June 12, 2014 Comments off

Prescription Drug Abuse (PDF)
Source: Congressional Research Service (via National Association of Chain Drug Stores)

An estimated 6.8 million individuals currently abuse prescription drugs in the United States. Unlike policy on street drugs, federal policy on prescription drug abuse is complicated by the need to maintain access to prescription controlled substances (PCS) for legitimate medical use. The federal government has several roles in reducing prescription drug abuse.

European Drug Report 2014: Trends and developments

June 2, 2014 Comments off

European Drug Report 2014: Trends and developments
Source: European Monitoring Centre for Drugs and Drug Addiction

How many new drugs were detected in Europe over the last year? Is cannabis getting stronger? How many Europeans have ever used an illicit drug? What are the latest drug policy developments in the region? These are just some of the questions explored in the European Drug Report: Trends and developments. This report provides a top-level overview of the long-term drug-related trends and developments at European level, while homing in on emerging problems in specific countries. Such a perspective is valuable, as it allows differing national experiences to be understood within the broader European context.

Healthcare Inspection – VA Patterns of Dispensing Take-Home Opioids and Monitoring Patients on Opioid Therapy

May 29, 2014 Comments off

Healthcare Inspection – VA Patterns of Dispensing Take-Home Opioids and Monitoring Patients on Opioid Therapy
Source: U.S. Department of Veterans Affairs, Office of Inspector General

As requested by the Senate Committee on Veterans’ Affairs, the VA Office of Inspector General assessed the provision of VA outpatient (take-home) opioids and monitoring of patients on opioid therapy. The population consisted of nearly half a million patients who were not receiving hospice/palliative care and who filled at least 1 oral or transdermal opioid prescription from VA for self-administration at home in FY 2012. The average and the median patient age was 59.4 and 61, respectively, and nearly 94 percent of them had been diagnosed with either pain or mental health issues and 58.4 percent with both. We determined that take-home benzodiazepines were dispensed to 7.4 percent of the study population, and 71 percent were dispensed concurrently with opioids. Take-home acetaminophens were given to 92.3 percent of the patients, and 2.0 percent of them were given an average daily dose that exceeded the maximum recommended daily dose of 4 grams. We found that 38.8 percent of the patients received medication management or pharmacy reconciliation. We determined that 6.4 percent of the new patients received both a urine drug test (UDT) prior to and a follow-up within 30 days of therapy initiation, that 37.0 percent of the existing opioid patients received both an annual UDT and a follow-up contact within 6 months of each filled opioid prescription, and that 10.5 percent of active substance use patients received both treatment for substance use and a UDT within 90 days of each filled opioid prescription. Even for the subpopulation of 19,724 active substance use patients who were on opioids for more than 90 days in FY 2012, we determined that only 18.8 percent of them received both a substance use disorder treatment in the FY and a UDT for each 90 days on opioids. We made six recommendations.

Primary Care Behavioral Interventions to Reduce Illicit Drug and Nonmedical Pharmaceutical Use in Children and Adolescents: U.S. Preventive Services Task Force Recommendation Statement

May 7, 2014 Comments off

Primary Care Behavioral Interventions to Reduce Illicit Drug and Nonmedical Pharmaceutical Use in Children and Adolescents: U.S. Preventive Services Task Force Recommendation Statement
Source: Annals of Internal Medicine

Description:
Update of the 2008 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for illicit drug use.

Methods:
The USPSTF reviewed the evidence on interventions to help adolescents who have never used drugs to remain abstinent and interventions to help adolescents who are using drugs but do not meet criteria for a substance use disorder to reduce or stop their use.

Population:
This recommendation applies to children and adolescents younger than age 18 years who have not been diagnosed with a substance use disorder.

Recommendation:
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of primary care–based behavioral interventions to prevent or reduce illicit drug or nonmedical pharmaceutical use in children and adolescents. (I statement)

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