Monday, July 23, 2007

The Flip Side of Medication Noncompliance

I usually focus on the negative effects that cause harm to people's health by not taking medications when talking about medication noncompliance, but there is the other side which accounts for abuse. If you think about all those people who are/were addicted to OxyCotin - the scripts had to come from somewhere.

I remember in college a friend always had a prescription of Valium and Percodan (or of that family). Not that she really needed them, but her doctor gave it to her "just in case". I believe there was some recreation use, not only by her but others. I also remember reading a piece a few years ago about kids trading medications. I'll have to find it.

Here is a piece addressing prescription abuse and medication noncompliance from MyWestTexas by Colin Guy:

A study recently completed by Midland-based Ameritox found that out of 240,000 long-term chronic pain patients, 77 percent were not in strict compliance with their physician's instructions.

Ameritox, a company that performs urine analysis for physicians' patients, found 11 percent of all samples contained illicit substances such as cocaine and marijuana and 30 percent of the samples contained prescription drugs that were not prescribed by the patients' doctors.

The study also found 13 percent of the urine samples contained a dosage of medication below the expected range and 30 percent did not contain any of the prescribed medication.

Tobyn Dyer, lab operations manager for Ameritox, told the Reporter-Telegram that in some instances this could indicate patients acquire prescriptions and sell the narcotics on the black market rather than take them as prescribed.

"Diversion is a big issue with the street value of drugs," he said.

According to Ameritox Chief Executive Officer Ancelmo Lopes, the misuse and abuse of prescription pain medication is costing taxpayers an estimated $8.5 billion per year including Medicare and Medicaid expenditures and the cost of treating patients at emergency rooms.

Dennis Wilson, a licensed chemical dependency counselor and program coordinator for Turning Point, told the Reporter-Telegram that many of the people in rehabilitation are abusers of prescription medications. He indicates even the legitimate use of narcotics may lead people with addiciton or a predisposition to addiction to fall into a pattern of substance abuse.

"If a doctor prescribes a 30-day supply it usually lasts 10 days, then five days, then two days," he said. Doctors typically have no way of knowing that their patients are misusing prescription medications unless the patient divulges their addictive tendencies, Wilson said, and are often unaware that prescribing a powerful narcotic could interfere with their rehabilitation efforts.

He said clients are encouraged to recognize the potential for abuse if they use narcotics to treat ailments and to look into alternatives such as non-narcotic painkillers and over-the-counter medications.

According to a press release issued by Ameritox, a Cornell University study found that doctors were unable to detect a patient misusing medications as much as 90 percent of the time and were also likely to mistakenly identify patients who are in compliance as medication abusers.

Ameritox's RxGuardian program, which provides feedback to doctors on what their patients are taking, is intended to help address this problem, Lopes said.

"Even within our own data these are pretty startling numbers," he said. "What Ameritox is trying to do is help physicians monitor their patients who have chronic pain. If they are not taking the medications appropriately doctors can try to get them back to their prescribed regimen."

1 comment:

Kurt P Fargo ND said...
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