Sunday, December 22, 2013

Is Florida Turning a Corner?

According to a brand new study, published online this week in the journal, Pharmacoepidemiology and Drug Safety, Florida's recent legislative actions to 1.) strengthen the state's prescription drug monitoring program, and 2.) toughen the regulation of the state's pain clinics, seem to be having the desired effect: drug diversion has been dropping steadily since 2011. In addition, according to the state's commission of medical examiners, prescription opioid overdose deaths are dropping too. Here's the abstract from the article and a figure of the models of longitudinal change, according to each drug: 

Reductions in prescription opioid diversion following recent legislative interventions in Florida
Surratt, et al., 2013

Purpose
Florida has been at the center of the nation's ongoing prescription opioid epidemic, with largely unregulated pain clinics and lax prescribing oversight cited as significant contributors to the opioid problem in the state.

Methods
In an effort to mitigate prescription opioid abuse and diversion in Florida, legislative interventions were implemented during 2010 and 2011, which included two primary elements: (i) comprehensive legislation to better regulate the operation of pain clinics; and (ii) a statewide prescription drug monitoring program to promote safer prescribing practices. Using systematic longitudinal data collected on a quarterly basis from law enforcement agencies across Florida, this report examined changes in prescription opioid diversion rates following implementation of these regulatory initiatives. Quarterly diversion rates for buprenorphine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone, and tramadol were calculated, and subsequently, hierarchical linear models were fit to test for differences in diversion rates over the 15 quarter period of interest.

Results
Significant declines in diversion rates were observed for oxycodone, methadone, and morphine; hydrocodone displayed a marginally significant decline.

Conclusions
This study documented reductions in statewide opioid diversion rates following implementation of Florida's pain clinic and prescription drug monitoring program legislative interventions. Although these initial findings appear promising, continued surveillance of diversion is clearly warranted. Copyright © 2013 John Wiley & Sons, Ltd.


3 comments:

  1. Regulation is working. Good. doc's still need to be more responsible

    ReplyDelete
  2. This may be good news, but only if these changes have not interfered with access to opioids by patients in genuine need, intimidated physicians into curtailing legitimate opioid prescribing, or resulted in mass migration from prescription opioids to heroin. All too often with gov't efforts to control the abuse, diversion and overdose of prescription opioids, the 'war on drugs' approach degenerates into a war on doctors and pain patients.
    Mark Edmund Rose, MA.
    Licensed Psychologist

    ReplyDelete
    Replies
    1. Well said. Unfortunately, it looks like a rise in heroin use and overdose deaths are becoming more common unintended consequences:
      http://news.wfsu.org/post/florida-prescription-drug-crackdown-blamed-part-spike-heroin-deaths

      Delete