Evidence Identification- Opioid Abuse and Misuse
According to Ling, Mooney & Hillhouse (2011), the misuse of prescription opioids has increased threefold in the United States since the 90s, reaching epidemic proportions. Indeed, some have referred to this current epidemic as the worst in the United States, with an estimated 92 million people addicted to prescription opioids as of 2015, and more than 3300 opioid-related deaths in the same year. Indeed, as per Vadivelu, Kai, Kodumudi, Sramcik & Kaye (2018), 52,000 people died in 2015, and 63,000 deaths were registered in 2016 due to drug overdoses, and 30,000 out of these were due to opioids abuse.
Opioid misuse is associated with a variety of physical, medical, and social issues. First, opioid abuse is related to a range of other medical problems, including respiratory infections, infectious disease transmissions, and engagement in potentially risky behaviors. For instance, opioid misuse is linked to a higher risk of contracting diseases such as HIV/AIDS and Hepatitis C. On one example, drug users living with HIV/AIDS have a higher death rate compared to any other demographic. Furthermore, as Ling, Mooney & Hillhouse (2011) point out, the rate of opioid overdose deaths was substantially higher among people whose common route of infection included drug injection use.
Opioid use is also associated with mental health issues and personality problems. Many studies attest to the fact that more than half of opioid abusers suffer from a mental illness or disorder. A study by Dr. Mark Sullivan evaluated the drug use problem by conducting a longitudinal study among 6439 participants collected between 1998 and 2001 in waves of healthcare for communities. As of this study, 237 participants reported regular use of opioids and patients who reported drug use problems reported higher use of prescription opioid use compared to those without drug problem use. The study concluded that common mental health disorders and issues are associated with the initiation and use of prescribed opioids, and related research from observational research suggests an association between mental disorders and opioid use. Besides, the study points out paying attention to psychiatric disorders as an essential element when conducting opioid therapy.
Opioid misuse is a severe issue warranting change, more so due to the devastating financial, social, psychological, and economic impacts it has on individuals, families, and the economy at large. Financially, opioid abuse has caused a dent in many individuals and families and is considered one of the reasons behind the growing number of homelessness among individuals in the United States. It has also contributed to breaking families and the disintegration of social and familial fabrics. Indeed, opioid abusers are more likely to engage in socially unacceptable behaviors, such as prostitution, to fuel their drug habits.
Evidence Description
As part of the processes of curbing opioid abuse and misuse, many states have implemented drug monitoring programs, which are used to collect, sort, monitor, and analyze data from pharmaceuticals and medical practitioners. In fact, according to Finley et al. (2017), 49 out of the 50 American states have implemented electronic drug monitoring prescription programs (PDMPs), which track scheduled medications from pharmaceuticals in a bid to curb prescription misuse.
In review and assessment of drug monitoring programs, Aditya et al. (2018), conducted a systemic study of drug monitoring programs, by focusing on the literature review of selected studies. The author initiated the literature review using PubMed database, which acted as a source of literature used in the analysis. Twenty-seven publications were used in the research, five of which represented a time-series analysis, and nine, which used a questionnaire, survey, or interview. For this evidence description, other methods used were a mixed-methods approach of research, and longitudinal as well as cross-sectional studies. The PRISMA approach was used to guide the selection of papers basing on one perspective or topic. Some of the reviews used in this research included: a study by Al Akchar et al. (2018), which compared the volume of prescription drugs before and after implementation of opioid prescribing medication rules. Another study, by Deyo et al. (2018), was used to determine if the use of Prescription Drug Monitoring Programs (PDMP), was associated with fewer risks of overdose events. Rutkow et al. (2017) were used to learn about PDMP, staff, law enforcement officials, and employees’ attitudes and experiences with PDMP. According to the authors, establishing a conceptual framework in areas of PDMP is essential, as it would help in the evaluation of areas of strength and weaknesses in PDMP, as well as practical improvement.
On the other hand, Worley (2014) conducted a study on PDMP and its purpose, responsiveness, and future research. The author focused on literature studies from health science databases: seven articles from reference lists were used, and 11 peer-reviewed research papers identified for research. Some were pharmacy journals, others from substance abuse journals, two from medical journals, and a government report as well. The author focused her research by basing on four different themes, namely: PDMP’s effect on prescribing opioids, multiple patients and provider characteristics, and the perspectives of health care professionals on PDMP. The work of this author has been significant in the study of drug monitoring programs, and it has revealed the need for more research on this topic. As Worley indicates in her study, relatively few research studies have been conducted on PDMPs, and many research studies that have been conducted are outdated. The author recommended that more studies needed to be done on barriers to PDMP use, and the interventions needed to counter such barriers.
Conclusion
Basing on the studies evaluated above, it is clear that as much as PDMP are valuable in concept, and their effectiveness still needs to be proven. PDMPs have revolutionized opioid monitoring by providing relevant and timely data, which can avert diversion and decrease the risks of abuse and overdose of opioids. As various studies suggest, going forward, further improvements on drug monitoring programs are needed to improve accuracy, accessibility, and the interpretability of data. The studies also point out the need for more funding to study and integrate data from drug monitoring programs into medical records. While we may be at a critical period in the opioid epidemic, with the right interventions, and the use of drug monitoring programs, the opioid epidemic can be averted.
References
LING, W., MOONEY, L., & HILLHOUSE, M. (2011). Prescription opioid abuse, pain, and
addiction: Clinical issues and implications. Drug and Alcohol Review, 30(3), 300-305. Doi: 10.1111/j.1465-3362.2010.00271.x
Vadivelu, N., Kai, A., Kodumudi, V., Sramcik, J., & Kaye, A. (2018). The Opioid Crisis: a
Comprehensive Overview. Current Pain and Headache Reports, 22(3). Doi:10.1007/s11916-018-0670-z
Finley, E., Garcia, A., Rosen, K., McGeary, D., Pugh, M., & Potter, J. (2017). Evaluating the
impact of prescription drug monitoring program implementation: a scoping review. BMC Health Services Research, 17(1). Doi: 10.1186/s12913-017-2354-5