Programs That Monitor Opioid Painkillers May Drive Some to Heroin

Programs That Monitor Opioid Painkillers May Drive Some to Heroin

Prescription drug monitoring programs are touted as a way to reduce overdoses from opioid painkillers, but they might have the unintended effect of increasing heroin overdose deaths, researchers say.

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They reviewed 17 studies that assessed the impact of these programs and found that 10 of them linked the programs to reductions in opioid overdose deaths. But three studies found that heroin overdose deaths rose after the programs were implemented.

"This suggested to us that heroin substitution may have increased after … restrictions on opioid prescribing," said study co-senior author Dr. Silvia Martins, an associate professor of epidemiology at Columbia University's School of Public Health in New York City.

"We therefore caution that programs aimed at reducing prescription opioids should also address the supply and demand of illicit opioids," Martins said in a university news release.

Opioid prescribing in the United States rose 350 percent between 1999 and 2015, and the rate of overdose deaths from both prescription opioids and heroin also increased exponentially during that time.

The drug-monitoring programs use centralized statewide data systems to track prescription data, which can identify patients who may be abusing opioids or doctors who are overprescribing the drugs, the study authors explained.

All 50 states and the District of Columbia have either implemented such a program or have passed legislation to introduce one.

"As such, it is crucial to determine if these programs are helping to reduce opioid overdose," said study first author David Fink, a doctoral candidate in epidemiology at Columbia.

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"So far, the definitive conclusion we can draw from our evaluation is that the evidence is insufficient and that much more research is needed to identify a set of 'best practices,' " he said.

The study was published online May 7 in the journal Annals of Internal Medicine.

More information

The U.S. Centers for Disease Control and Prevention has more on prescription drug monitoring programs.


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