Editorial: Prescription abuse

Florida‘s medical examiners recently reported that prescription medicines caused more deaths in 2008 than illicit drugs. The medical examiners also reported sharp increases in deaths caused by prescription tranquilizers and painkillers, such as Oxycodone and hydrocodone.

The results of the year-end report weren’t surprising. Since the middle of last year, physicians, pharmacists and law enforcement officials have warned of a near-epidemic of deadly prescription medicine abuse. In 2005, the Medical Examiners Commission began reporting the drugs discovered in bodies subject to autopsies. The percentage of decedents with at least one drug in their bodies has increased each year; to 53 percent last year.

“The vast majority” (4,924) of the 8,556 drug-related deaths studied last year by the state’s medical examiners involved the presence of more than one drug, according to the 2008 report. The presence of at least one prescription drug caused the death of 2,184 people last year.

To put the scale of those numbers in perspective, consider: There were 2,983 deaths on Florida’s roads last year; 1,169 of those fatalities were alcohol-related. Prescription drugs caused more deaths than alcohol-related crashes in Florida.

Of particular concern: Death-related occurrences of both benzodiazepines and oxycodone were up by more than 20 percent in 2008 compared with 2007. The drugs that caused the most deaths in Florida: oxycodone (941), benzodiazepines (929), methadone (693), cocaine (648), alcohol (489), morphine (300), hydrocodone (270).

This year, the Legislature finally passed a law that calls for creating an electronic database to monitor the prescription and sale of certain painkillers and tranquilizers. The database should help investigators track the worst offenders once it is operational next year, but even proponents of the law concede it was watered down.

Other initiatives are likely to be necessary because the personal and societal problems associated with the misuse of prescription drugs aren’t getting better.

AMA Unveils Enhanced ePrescribing Learning Center to Provide Physicians Tools to Make Informed Decisions About Electronic Prescribing

Earlier this year the American Medical Association (AMA) launched a new online learning center to provide physicians with the information and tools they need to make informed decisions about electronic prescribing (ePrescribing). Today, the AMA unveils enhanced tools for ePrescribing and opens the site and all its resources to all physicians.

“A recent survey found about 30 percent of physician participants use an ePrescribing system in their practice. This is a sizable increase from the 13 percent who said the same at the end of last year,” said AMA Board Member Joseph M. Heyman, MD.

“With the current Medicare ePrescribing incentive and the promise of increased patient safety and practice efficiency, physician interest in adopting new technologies is increasing. We are glad to be able to offer physicians guidance on ePrescribing.”

The learning center includes a variety of tools and resources to help physicians, including calculators to estimate time savings and eligibility for incentive payments and planning tools to help determine practice readiness for and ease implementation of new technologies. Some of the new tools include:

• A system finder tool that selects three systems for a user based on their responses to a brief questionnaire
• Side-by-side comparisons of up to three ePrescribing vendors at one time
• The ability to read vendor feedback and ratings from other users, and provide your own vendor feedback
• Automated contact a vendor capability for when a decision is reached.

“Health information technology continues to be a hot issue in health care, and electronic prescribing can be a physician’s first step into health IT,” said Dr. Heyman. “Incorporating an ePrescribing system into your practice can help reduce medication errors and drug interactions and also help prepare the practice for future technologies like electronic health records.”