Trust No One - Opiate Database Rx Counts

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Patients may still have opiate abuse or dependence even if they have no prescriptions recorded on a public controlled-substance database.

Why does this matter?
State run prescription drug monitoring programs (PDMP) have been helpful in curtailing prescription drug abuse.  They provide valuable intelligence about what controlled substances a patient has recently had filled, assuming they are obtaining them legally.  But one may have a false sense of reassurance if the PDMP shows no filled controlled substances.

"Trust no one." Corey Slovis
There was a rough correlation between number of prescriptions on a PDMP and self-reported use of an opiate 1-14 days/month or >/=15 days/month.  The more prescriptions on the PDMP, the more self-reported drug use, from both prescription and non-prescription (illicit) sources.  But the correlation was loose.  For example, among patients with no prescriptions in the PDMP, 28% voluntarily reported using opiates >/= 15 days/month.  The take home of this study was that we can't be falsely reassured by a PDMP showing no opiate prescriptions filled.  Patients can have a serious opiate use disorder and not have any prescriptions on file with the state monitoring program.

Source
Past-year Prescription Drug Monitoring Program Opioid Prescriptions and Self-reported Opioid Use in an Emergency Department Population with Opioid Use Disorder. Acad Emerg Med. 2017 Nov 22. doi: 10.1111/acem.13352. [Epub ahead of print]

Peer reviewed by Thomas Davis, MD.  

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