Strategies for Identifying & Preventing Prescription Drug Misuse

Over the last several years, the misuse of prescription drugs has become an epidemic in the United States. While many are aware of the opioid epidemic, the United States is still facing a major drug crisis in 2024.

According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2023 National Survey on Drug Use and Health, “among the 8.9 million people who misused opioids in thepast year, about 8.6 million misused prescription pain relievers”¹. Tackling this issue requires a multifaceted approach involving providers, pharmacists, PBMs, patients and the community. In this article, we put together some strategies to help identify and prevent prescription drug misuse from continuing.

Providers
Healthcare providers play a crucial role in identifying and addressing prescription drug misuse. Not only do providers have direct access to patients to monitor their health and look for warning signs of abuse, but they also have access to drug monitoring databases. "The creation of electronic databases known as prescription drug monitoring programs (PDMPs), is used to track the prescribing and dispensing of prescription drugs to patients. This serves as an important tool in identifying and preventing prescription drug misuse”². By accessing PDMP data, providers can make more informed decisions about prescribing and refer
patients to appropriate treatment if necessary. In some states, access to these databases has resulted in lower rates of opioid prescriptions as well as lower rates of opioid-related deaths².

Pharmacists
Pharmacists can serve as the first line of defense against drug misuse. Pharmacists should be reviewing usage and checking for falsified prescriptions. In addition, a pharmacist should make sure an individual is aware of how their medication works and provide the individual with dosage instructions to ensure safe usage².

Prescription Benefit Managers (PBMs)
As intermediaries between insurance providers, pharmacies, and pharmaceutical companies, PBMs have significant influence over the distribution and utilization of prescription drugs.

One key strategy employed by PBMs is implementing strict clinical review processes for opioid prescriptions which helps ensure these powerful medications are only used when medically necessary and appropriate. This can prevent unnecessary overprescribing and limit the availability of opioids that could potentially be misused.

PBMs also work to promote the use of abuse-deterrent formulations of opioid medications. These specialized products are designed to make it more difficult for individuals to extract and misuse the active ingredients. By incentivizing the use of these formulations, PBMs can help reduce the risk of diversion and illicit use.

Patients & Community
Patients must also do their part by monitoring their medications. This includes following directions provided by their doctor, being aware of their medication's interactions with alcohol, consulting with their doctor before making any adjustments to their regimen, never using another’s prescriptions, and storing dangerous drugs in safe places².

Another important strategy is the promotion of safe disposal options for unused or expired prescription medications. By making it easier for individuals to properly dispose of these drugs, we can reduce the risk of them being diverted or accidentally ingested by others. This can include the establishment of take-back programs, secure drop-off locations, and public education campaigns.

By leveraging the expertise and resources of healthcare providers, pharmacists, and PBMs, it is possible to develop a comprehensive and effective response to the prescription drug abuse crisis and help communities overcome the devastating impact of this public health emergency.

Sources:
1: https://www.samhsa.gov/data/sites/default/files/NSDUH%202023%20Annual%20Release/2023-nsduh-main-highlights.pdf  
2: https://nida.nih.gov/publications/research-reports/misuse-prescription-drugs/how-can-prescription-drug-misuse-be-prevented#:~:text=Prescription%20drug%20monitoring%20programs%20(PDMPs,and%20identifying%20prescription%20drug%20misuse.