Prescription monitoring programs: Helpful or harmful?

The crushing toll of the opioid crisis is daily news, including stories about ways to “fix” it. A wide array of initiatives has been brought forward in an attempt to curb this epidemic and the damage it causes. Prescription monitoring programs (PMPs) are one of them. The goal of PMPs is a good one — to identify patients who are being prescribed multiple medications by multiple clinicians. It is a means to introduce some stewardship for preventing overuse and misuse of prescription drugs. How prescription monitoring programs work Prescription monitoring programs are state-based electronic databases that provide a way to track prescriptions, specifically controlled substances including opioids, benzodiazepines, and amphetamines. They are intended to support access to legitimate medical use of these drugs, and to help identify and deter drug misuse and diversion (when medications are not used by the person for whom they were prescribed). Currently 49 states, the District of Columbia, and Guam have PMPs, and in many states providers must access the PMP before prescribing a controlled substance. PMPs have had some success, with several states demonstrating an overall decrease in prescription opioid overdose after implementation. At the same time, there are several challenges hindering effective use of prescription monitoring programs, including issues of lag time, state to state variability, and important privacy concerns. These issues need to be addressed as thi...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Addiction Drugs and Supplements Health Source Type: blogs

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In this study, we examine how the frequency of SNS use is associated with active travel (i.e., walking and cycling) and body mass index (BMI) in the Glasgow and Clyde Valley Planning area, Scotland. We employ both a self-reported measure of active travel from a travel diary (N = 1684) and an objective measure of average walking hours from Global Positioning System (GPS) data (N = 282) collected in 2015. These are analysed with statistical models (i.e., binomial logistic regression, multinomial logistic regression and linear regression models). We find that there is no significant association between the frequency o...
Source: Journal of Transport and Health - Category: Occupational Health Source Type: research
Publication date: October 2018Source: The Lancet Neurology, Volume 17, Issue 10Author(s): Maria A Rocca, Frederik Barkhof, John De Luca, Jonas Frisén, Jeroen J G Geurts, Hanneke E Hulst, Jaume Sastre-Garriga, Massimo Filippi, Frederik Barkhof, Olga Ciccarelli, Nicola De Stefano, Christian Enzinger, Massimo Filippi, Jette L. Frederiksen, Claudio Gasperini, Ludwig Kappos, Jacqueline Palace, Maria A. Rocca, Alex Rovira, Jaume Sastre-GarrigaSummarySome of the clinical manifestations of multiple sclerosis, such as memory impairment and depression, are, at least partly, related to involvement of the hippocampus. Pathologi...
Source: The Lancet Neurology - Category: Neurology Source Type: research
Publication date: October 2018Source: The Lancet Neurology, Volume 17, Issue 10Author(s): The Lancet Neurology
Source: The Lancet Neurology - Category: Neurology Source Type: research
Publication date: October 2018Source: The Lancet Neurology, Volume 17, Issue 10Author(s): Nicholas D James, Stephen B McMahon, Edelle C Field-Fote, Elizabeth J BradburySummaryNeuromodulation, the use of electrical interfaces to alter neuronal activity, has been successful as a treatment approach in several neurological disorders, including deep brain stimulation for Parkinson's disease and epidural spinal stimulation for chronic pain. Neuromodulation can also be beneficial for spinal cord injury, from assisting basic functions such as respiratory pacing and bladder control, through to restoring volitional movements and ski...
Source: The Lancet Neurology - Category: Neurology Source Type: research
ConclusionThe presence of a correlation between the mentalization and stigma perception in our study demonstrates that these two concepts are connected and that this connection needs further study. In particular, mentalization-based therapy can have an effect on the reduction of the stigma perceptions and in this way can improve the course of the disease, potentially improving the patients' quality of life.
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
This article is part of the Special Issue “Neurostimulation for Epilepsy”.
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
Source: BMJ Comments - Category: General Medicine Source Type: forums
Source: BMJ Comments - Category: General Medicine Source Type: forums
This past week, Governor John Kasich of Ohio issued an executive order limiting the amount of opioids doctors and dentists can prescribe to no more than a 7 day supply. Failure to comply could result in disciplinary action, including loss of license. Exceptions exist only for patients with cancer or those enrolled in hospice programs. For all the rest, it represents a hard full stop. No longer will the chronic pain sufferer, the woman status post lumbar back fusion x 3, be able to get a prescription for a month's supply of oxycodone with 3 refills.On the surface this appears to be a reasonable initiativ...
Source: Buckeye Surgeon - Category: Surgery Authors: Source Type: blogs
"If you do not change direction, you may end up where you are heading." -- Lao Tzu Over the last few weeks, the CDC, the U.S. Department of Health and Human Services (HHS), and the president of the United States have all separately hit the emergency button over the subject of chronic pain treatment and opioid pain killers. Concerns over the rising tide of pain killer addiction, accidental overdose deaths, and a carryover effect causing a steep rise in heroin use have made this a "code blue" emergency for Washington. President Obama has made it clear that addressing the opioid epidemic is now an administ...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
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