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Use of multiple pharmacies can predict opioid overdosing

Date:
July 1, 2015
Source:
American Pain Society
Summary:
Almost half of deaths attributed to prescription opioids were Medicaid recipients, and using multiple pharmacies to fill prescriptions is linked with opioid overdoses, a new study concludes.
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A study conducted in the state of Washington and reported in The Journal of Pain showed that almost half of deaths attributed to prescription opioids were Medicaid recipients, and using multiple pharmacies to fill prescriptions is linked with opioid overdoses. The Journal of Pain is published by the American Pain Society.

In many states, Medicaid programs monitor the number of pharmacies visited to determine risk for misuse or abuse of opioid medications. Pharmacy shopping can be a way to obtain more opioid prescription drugs than medically necessary.

Despite knowing that using multiple pharmacies is linked with drug misuse, there is no consensus regarding the threshold number of pharmacies or specified length of time that can define pharmacy-shopping behavior. Further, there is a risk that relying on pharmacy shopping as an indicator of opioid misuse could misidentify patients who legitimately have used multiple pharmacies due to insurance coverage changes, moving, traveling and vacations.

For the study, a multicenter team of researchers examined records of more than 90,000 Medicaid enrollees who used three or more opioid prescriptions for 90 days in 2008 through 2010. The study population was limited to a cohort of Medicaid enrollees ages 18 to 64 who were long-term opioid users.

Results of the analysis showed that within a 90-day interval a threshold of four pharmacies had the highest diagnostic odds ratios for opioid overdose events, and could be considered as an indicator for pharmacy shopping. Further, the overdose rate was higher within a subgroup with overlapping prescriptions.

The authors recommended that for patients whose use of overlapping prescriptions and multiple pharmacies cannot be justified medically, patient review and restriction programs (PRRs) could restrict reimbursement for controlled prescription drugs to a single designated physician and one pharmacy.


Story Source:

Materials provided by American Pain Society. Note: Content may be edited for style and length.


Journal Reference:

  1. Zhuo Yang, Barth Wilsey, Michele Bohm, Meghan Weyrich, Kakoli Roy, Dominique Ritley, Christopher Jones, Joy Melnikow. Defining Risk of Prescription Opioid Overdose: Pharmacy Shopping and Overlapping Prescriptions Among Long-Term Opioid Users in Medicaid. The Journal of Pain, 2015; 16 (5): 445 DOI: 10.1016/j.jpain.2015.01.475

Cite This Page:

American Pain Society. "Use of multiple pharmacies can predict opioid overdosing." ScienceDaily. ScienceDaily, 1 July 2015. <www.sciencedaily.com/releases/2015/07/150701094508.htm>.
American Pain Society. (2015, July 1). Use of multiple pharmacies can predict opioid overdosing. ScienceDaily. Retrieved May 23, 2017 from www.sciencedaily.com/releases/2015/07/150701094508.htm
American Pain Society. "Use of multiple pharmacies can predict opioid overdosing." ScienceDaily. www.sciencedaily.com/releases/2015/07/150701094508.htm (accessed May 23, 2017).

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