The misuse and abuse of prescription medicines in the U.S. has risen dramatically in recent years, threatening grave harm to families and communities across the country. Committed to the appropriate use of prescription medicines, PhRMA has been actively engaged in promoting strong public policies and a coordinated approach across the public and private sectors to tackle this growing public health crisis.
Recent studies suggest that the problem of prescription drug abuse in the U.S. today does not largely stem from drugs that have been illegally diverted from the manufacturing supply chain. Increasingly, these medicines are often obtained from family and friends who obtained them with a legal, medically-appropriate prescription. This highlights the need for the safe disposal of medicine in consumer households. The Drug Enforcement Administration (DEA) announced last week that it would allow people to return unused prescription medications – including opioid painkillers – to pharmacies and hospitals, in an attempt to reduce the likelihood that someone in the household might inappropriately obtain and abuse these medicines. DEA’s guidance provides a greater array of options to the public for properly disposing of unused medicines, including safe in-home disposal, “take back” events, and direct mail to authorized collectors. While questions remain about the implications of DEA’s recently released regulations, PhRMA has long supported voluntary take back programs as well as educating the public about proper in-home disposal options.
While educating the public about the proper storage and disposal of unused medicines is a critical first step to helping reduce the potential misuse and abuse of prescription medicines, more must be done. PhRMA supports a range of additional public policy changes to address this problem. Primary among policy options is strengthening prescription drug monitoring programs (PDMPs), which are intended to help identify and prevent abusers from obtaining multiple prescriptions of controlled substances for which they do not have a legitimate medical need. These state-run electronic databases, like those used in Ohio and Kentucky, have proven very effective in helping officials prevent “doctor-shopping” and inappropriate prescribing. Fostering the sharing of data among and between states would enhance states’ ability to deter and prevent the abuse of controlled substances. To this end, PhRMA supports ensuring states have the appropriate health information technologies in place to facilitate interoperability. For example, PhRMA supports the National Association of Boards of Pharmacy’s efforts to facilitate inter-operability, which could potentially serve as a pilot for other states.
PhRMA also strongly supports expanding efforts to identify and shut down facilities and online websites that inappropriately provide access to controlled substances. In contrast to legitimate healthcare providers, so-called “pill mills” are interested in their own financial reward rather than in the medical needs of their patients. In order to protect legitimate entities and clearly distinguish them from bad actors, any legislation or model state law proposed to prevent prescription drug abuse should include very specific training and inspection requirements, as well as relevant statutes and regulations with which pain clinics must comply. Similarly, PhRMA supports expanding DEA’s ability to prosecute online pharmacies that not in compliance with Federal law.
To complement the above efforts, a number of additional steps should be taken. The provider community must increase education efforts regarding appropriate prescribing practices and the use of PDMPs as well as conduct more trainings on how to screen for, briefly intervene, and refer for treatment those suspected of misusing and abusing prescription medicines. The innovative biopharmaceutical community, and the agencies that regulate it, must do its part to support the development of abuse-deterrent formulations for some medicines that are susceptible to widespread abuse.
PhRMA takes our mission of advancing public health seriously, and preventing prescription drug abuse is a vital part of that undertaking. In doing so, we will continue to be active participants in finding solutions to this alarming problem.