, Salem, MA


April 9, 2014

Column: A physician's perspective on opiate abuse


Physicians are not standing on the sidelines. We have had multiple discussions about solutions to the problem with legislators, patient advocates and other professionals who prescribe pain medications, as well as with representatives of the Department of Public Health and the Board of Registration in Medicine.

Twenty years ago, the Massachusetts Medical Society helped to establish the Prescription Monitoring Program. We have consistently provided input into the program. It remains the best tool we have to combat prescription drug abuse. An accurate and accessible database can provide data on all prescriptions, including prescriber, dispenser and patient usage. It can alert regulators to physicians who might be overprescribing or patients who might be “doctor shopping” for controlled substances.

We support the automatic enrollment of all prescribers and dispensers and call on them to participate fully in the program. We also believe improvements to the program, such as establishing real-time information and integrating the program into electronic health records, will enhance monitoring and reduce diversion of drugs.

Other actions should also be considered. As the respected CommonWealth Magazine has noted, no hard data exists on the state’s opiate problem. We need better and updated information. We must learn more about the source of these drugs: How many are stolen, taken from home medicine cabinets, obtained illegally from street dealers or out-of-state sources, or bought on the Internet? Answers to these questions will help target preventive efforts.

Pharmaceutical companies must play a role in assessing any discrepancies between the manufactured supply of medicines and actual patient demand, as their market studies usually include these estimates.

Drug take-back or return measures can be expanded. The Medical Society, for example, has advocated for legislation requiring pharmacies to have a “take back and disposal” policy for unused and expired medications.

We must also recognize the patient’s role. In the final analysis, the drugs are in the patient’s hands, and responsible use, storage and disposal are absolutely critical. More patient education is a must.

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