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Other Related Topics >> Laws, Regulations, and Enforcement

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sigmund
Member


Reged: 07/29/03
Posts: 181
Loc: Vienna
Prescription Rx Abuse Comprehensive Plan
      #143274 - 03/01/04 03:24 PM

Important Information

In reading the FDA website to get more information about the shortage of weight loss medication, came across the following link which lays out a 2004 update of policy and procedures of the War on Drugs. The government no longer considers itself to be finally enforcing the 2000 law, but has delineated a comprehensive plan to deal with all aspects of what they consider to be a prescription drug abuse epidemic.

http://www.fda.gov/oc/initiatives/rxdrugabuse/default.htm

Since the rationale, policy, procedures and enforcement are so extensive, suggest clicking on link to read selected sections.

anna22

--------------------
how can you tell the Dreamer from the one who dreams the dream?


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buey
Old Hand


Reged: 01/15/03
Posts: 453
Loc: USA
Re: Prescription Rx Abuse Comprehensive Plan [Re: sigmund]
      #143323 - 03/01/04 05:35 PM

I can't get this to open. anyone care to copy and post pertinent information on OPs?
Thanks


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night_shade
Threadhead


Reged: 08/26/03
Posts: 907
Loc: The State of Hockey
Re: Prescription Rx Abuse Comprehensive Plan [Re: buey]
      #143420 - 03/01/04 09:05 PM

opens fine for me--it's a PDF (so if you don't have Acrobat Reader, it won't open.)

Here's some of the text:

REDUCING PRESCRIPTION DRUG ABUSE
Non-medical use of addictive prescription drugs has been increasing throughout the United States at alarming rates. According to the National Survey on Drug Use and Health, in 2002, an estimated 6.2 million Americans reported past month use of prescription drugs for non-medical purposes. Nearly 14 percent of youth between the ages of 12 and 17 have used such drugs, which include pain relievers, sedatives/tranquilizers, or stimulants, for non-medical purposes at some point in their lives. Emergency room visits associated with narcotic pain relievers have increased 163 percent since 1995. The President’s National Drug Control Strategy engages Federal, state, and local officials; the medical community; and businesses working in the area of Internet commerce to prevent and stop the illegal sale, diversion, and abuse of prescription pshychotherapeutic drugs.
The Strategy focuses on three core tactics for reducing prescription drug abuse:
Business outreach and consumer protection
Investigation and enforcement against the illegal sale and diversion of prescription drugs
Education and training of physicians and consumers
Business Outreach and Consumer Protection: The Food and Drug Administration (FDA) will work to ensure product
labeling that clearly articulates conditions for the safe and effective use of controlled substances so that commercial advertising fully discloses safety issues associated with the drug’s use. Specific examples include labeling that properly identifies patients for whom these products are appropriate and that recommends a “stepped care” approach to the treatment of chronic pain, in accordance with treatment guidelines.
FDA will consider Risk Management Programs (RiskMAPs) during the approval process for Schedule II opiate drug products. RiskMAPs help ensure the safe prescription and use of these drugs through identification of appropriate
patients and monitoring for adverse outcomes.
FDA, the Drug Enforcement Administration (DEA), and the White House Office of National Drug Control Policy will work with physician organizations to encourage comprehensive patient assessment prior to prescription of opiate therapy. Identification of persons at risk for opiate abuse and addiction will help their medical caretakers to more effectively monitor for signs of abuse.
Federal agencies are enlisting the support of responsible businesses affiliated with online commercial transactions. Such businesses include credit card companies, shippers, and Internet Service Providers (ISP). These legitimate businesses will be asked to alert law enforcement officials to suspicious or inappropriate activities, while ISP and credit card companies will be requested to require Internet pharmacies to display on their websites the physical street address of their primary business locations.
Investigation and Enforcement: The Internet is one of the most popular sources of diverted prescription drugs. An increasing number of rogue pharmacies – or “pill mills” – offer controlled substances and other prescriptions direct to consumers online. These unscrupulous entities are often foreign-based and undermine state licensing systems, exposing consumers to potentially counterfeit, adulterated, and contaminated products.

The FDA’s Office of Criminal Investigations (OCI) and DEA work together on criminal investigations involving the
illegal sale, use, and diversion of controlled substances, including illegal sales over the Internet. Both FDA and DEA have utilized the full range of regulatory, administrative, and criminal investigative tools available, as well as engaged in extensive cooperative efforts with local law enforcement groups, to pursue cases involving controlled substances.
Investigation and Enforcement (continued):
DEA will deploy sophisticated web crawler/data mining technology to generate investigative leads that could lead to enforcement actions against illegal pill mills.
ONDCP and DEA will work with state officials to expand the number of Prescription Monitoring Programs (PMPs)
and to facilitate information sharing among jurisdictions. Currently, 20 states have PMPs to identify individuals who
attempt to fill multiple prescriptions from numerous doctors (“doctor shopping”). This information can help reputable physicians and pharmacies prevent illegal diversion of controlled substances.
FDA and U.S. Customs and Border Protection (CBP), with assistance from DEA, continue to do spot examinations of mail and courier shipments for foreign drugs to U.S. consumers to help FDA and CBP target, identify, and stop illegal and potentially unsafe drugs from entering the U.S. from foreign countries via mail and common carriers.
Education and Training: One potential means of preventing diversion and abuse of prescription drugs is wider dissemination of continuing medical education programs for physicians and other health professionals regarding pain management. These programs will seek to balance the legitimate needs of patients against the risk of diversion and abuse.

The DEA, with support from the FDA, is working to consult with medical associations to identify existing best practices in physician training in the field of pain management. The agencies plan to develop a mechanism to support the wider dissemination and completion of approved Continuing Medical Education (CME) courses for physicians who prescribe controlled substances. The curriculum will educate doctors on the appropriate medical use of opioids as well as the risks of abuse and addiction.
ONDCP, DEA, and FDA will develop public service announcements that appear automatically during Internet drug searching to alert consumers to the potential danger and illegality of making direct purchases of controlled substances online. Currently, FDA, along with its sister agency, the Substance Abuse and Mental Health Services Administration (SAMHSA), have jointly developed a public service announcement campaign to better educate consumers on the abuse of prescription pain killers.
Protecting Safe and Effective Use of Medications: Some estimate that more than 10 million Americans suffer from chronic pain. The efforts outlined in the National Drug Control Strategy to prevent and reduce the diversion and abuse of prescription drugs will help to ensure that patients have full and appropriate access to the medications that best meet their needs and that their healthcare providers are informed and trained to effectively manage pain while limiting potential for misuse, abuse, and addiction.
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And here's the LINK to their press release.
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Just another way for the government to get a piece of the pie--the almighty dollar pie.


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sam001
Journeyman


Reged: 02/03/04
Posts: 68
Loc: Nordstroms
Re: Prescription Rx Abuse Comprehensive Plan [Re: night_shade]
      #143462 - 03/01/04 10:53 PM

I find the notation of the increases in the emergency departments on the increase use/abuse questionable at best. I've worked in ERs and know how difficult it is to report reliable info to various agencies. Partly because the agency requesting information does not clearly identify the requirements. For example, during the flu epidemics, all cases that had only fever and some flu symptoms were reported and turned out to not actually be the flu. The reporting requirements were so vague, it was clearly someones best guess as to what to send to various agency. By the way, not all disease reporting is this vague, such as STD's.

The info that the government has put out recently said that Oxycodone and Hydrocodone "mentions" have increased in the Emergency Department records in the past few years. What exactly is a "mention". That the word occurs somewhere in the record? Maybe the doctor prescribed it. Or maybe the patient asked, "would vicodin help me?". So what if it's mentioned more. It shoud be. People are more assertive and dealing with healthcare professionals, and this is great. And narcotic "mentions" have overtaken benzodiazapines in "mentions" in the Emergency Department from 1995 to 2002. I don't know that "mentions" somehow equate to addiction, diversion and/or overdose. The vast majority of people seeking treatment in the ER is for pain relief. Let's also not forget with the decline of people covered with health insurance, ERs turn in to primary care facilities. So that the sprained ankle we had 5 years ago, we used to get our regular docs to call in a script and get an xray at the office the next morning. Those days are gone for many people as doctor's offices can turn away people without insurance or $$$. ERs can't.

Will some statistition please help me understand this. I really question drug abuse increases as a conclusion when the criteria is "mentions".

No doubt there is a desire by Bush to have a war on drugs, including prescription drugs. Manipulating data is not a new concept, it would be interesting to have some valid studies that would help deflate this process or give the opposition some ammunition to fight back. It's hard for me to swallow the "facts" that have been presented by Bush's new plan on dealing with prescription pain medication addiction.

Anna, thanks for posting this. Found it an interesting read.

My 2 cents.

Edited by sam001 (03/02/04 09:12 AM)


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Caveman6666
Enthusiast


Reged: 01/15/03
Posts: 218
Loc: Earth
Re: Prescription Rx Abuse Comprehensive Plan [Re: sam001]
      #143551 - 03/02/04 07:30 AM

Quote:

The info that the government has put out recently said that Oxycodone and Hydrocodone "mentions" have increased in the Emergency Department records in the past few years. What exactly is a "mention". That the word occurs somewhere in the record? Maybe the doctor prescribed it. Or maybe the patient asked, "would vicodin help me?".




Or some kid took one Hydro along with a quart of vodka, both stolen from his parents, and is in there for for alcohol poisoning, but happens to mention the one Hydro...


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buey
Old Hand


Reged: 01/15/03
Posts: 453
Loc: USA
Re: Prescription Rx Abuse Comprehensive Plan [Re: night_shade]
      #143558 - 03/02/04 07:45 AM

wow....scary big brother stuff. Thanks for posting that.

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night_shade
Threadhead


Reged: 08/26/03
Posts: 907
Loc: The State of Hockey
Re: Prescription Rx Abuse Comprehensive Plan [Re: Caveman6666]
      #143694 - 03/02/04 03:11 PM

Exactly, Caveman...

I would bet that most people remember to mention the narcotic pain meds when they forget to mention the OTC pain killers they have taken such as Tylenol and Advil. Probably because there is such a hype about these drugs.

Since I doubt there is any strict reporting criteria for these ERs, it would be impossible to rely on the statistical data noted in the government's reports.

And as we all know, statistics can be skewed to suit any purpose.

--------------------
Never underestimate the predictability of stupidity.


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