Impact of Prescription Drug Diversion Control Systems on Medical Practice and Patient Care

Transcription

1 Impact of Prescription Drug Diversion Control Systems on Medical Practice and Patient Care Editors: James R. Cooper, M.D. Dorynne J. Czechowicz, M.D. Stephen P. Molinari, J.D., R.Ph. Division of Clinical Research National Institute on Drug Abuse and Robert C. Petersen, Ph.D. NIDA Research Monograph U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service National Institutes of Health National Institute on Drug Abuse 5600 Fishers Lane Rockville, MD 20857

2 Contents Preface iii The Impact of Prescription Drug Control Systems on Medical Practice and Patient Care: A Summary of the NIDA Technical Review 1 Guiding Principles of International and Federal Laws Pertaining to Medical Use and Diversion of Controlled Substances 18 David E. Joranson Session: Medical Use, Therapeutic Rationale-Prescribing and Control Issues Therapeutic Use of Opioids: Prescribing and Control Issues 35 Russell K. Portenqy Anxiolytics: Indications, Benefits, and Risks of Short, and Long-Term Benzodiazepine Therapy: Current Research Data 51 Karl Rkkels and Edward Schweizer Issues and Controversies Regarding Benzodiazepine Use 68 Carl Sahman Stimulant Drugs-Medical Needs, Alternative Indications and Related Problems 89 Jonathan O. Cole, Lenore A. Boiling, and Barbara J. Peake vii

3 Session: Abuse and Diversion The Nonmedical Use of Prescription Drugs in the United States 109 Edgar H. Adams and Andrea Kopstein Drug Diversion Control Systems, Medical Practice, and Patient Care 120 Gene R. Haislip Session: Diversion Control Methods Existing Methods to Identify Retail Drug Diversion 132 G. Thomas Gitchel PADS Approach to Preventing Prescription Drug Diversion 141 John J. Ambre Diversion Investigation Units Methods, Utilities, and Limitations 145 R. Keith Bulla OSTAR-Oklahoma Schedule Two Abuse Reduction: An Electronic Point of Sale Diversion Control System 151 Elaine Dodd The Illinois Experience in Achieving the Medical/ Regulatory Balance Required to Control Prescription Drug Diversion 159 Mark T. Bishop and Ronald J. Vlasty New York State's Triplicate Prescription Program 176 John L. Eadie Triplicate Prescriptions in Washington State 194 Donald H. Williams Vlll

4 The Medicaid Prescription Drug Initiative 200 Thomas Roslewicz Summary and Conclusions of a Review of Prescription Drug Diversion Control Methods 206 Constance Horgan, Jeffrey Prottas, Christopher Tompkins, Linda Wastila, and Melissa Bowden Session: Impact on Medical Practice and Patient Care Professional Association Responses An American Medical Association Perspective on Preventing Prescription Drug Diversion 224 John J. Ambre Prescription Drug Regulation: Implications for Nursing and Health Care Delivery Response of the American Nurses' Association 228 Madeline A. Naegle Perspective of the American Pharmaceutical Association C. Edwin Webb Perspective of the Empire State Medical Association of the National Medical Association 239 Gerald Deas Prescribing Practices and Drug Abuse Perspective of the American Society of Addiction Medicine 242 Anne Geller Response of the American Academy of Child and Adolescent Psychiatry 246 Nicholas Rock IX

5 Advocacy Groups Impact of Drug Regulation and Diversion Control System on Legitimate Narcolepsy Patients Response of American Narcolepsy Association 249 Joseph A. Piscopo State Cancer Pain Initiatives 260 June L. Dahl Benzodiazepine Dependence-A Treatment Program Perspective 266 Robert D. O'Connor A Public Citizen Health Research Group Perspective on Federal Triplicate Prescription Requirements for Controlled Substance Prescription Drugs 270 Sidney Wolfe Session: Evaluation of the Impact on Medical Practice and Medical Care Consequences of the 1989 New York State Triplicate Benzodiazepine Prescription Regulations 279 Michael Weintraub, Satesh Singh, Louise Byrne, Kumar Maharaj, and Laurence Guttmacher Changes in Prescribing Patterns in Long-Term Care Facilities and Impact on Incidence of Adverse Events 294 Sergio I. Zullich, Thaddeus H. Grasela, Jill B. Fiedler-Kelley, and Francis M. Gengo Future Research Directions A Research Agenda for Prescription Drug Diversion Control 309 Constance Horgan, Jeffrey Prottas, Christopher Tompkins, Linda Wastila, and Melissa Bowden

6 The Impact of Prescription Drug Control Systems on Medical Practice and Patient Care A Summary of Research Recommendations 325 Dorynne Czechowicz Appendix List of May 30-June 1,1991 Technical Review Participants 331 List of October 3-4, 1991 Research Advisory Panel Participants 334 XI