Michigan health professionals said Monday the state's recommendations for curbing prescription drug abuse are on the right track, particularly the call for overhauling or replacing the current prescription monitoring program.
The 21-member Michigan Prescription Drug and Opioid Abuse Task Force, which Gov. Rick Snyder formed in June, released a report Monday (PDF) with about three dozen recommendations. They included a revamped, stricter prescription monitoring program, more training for physicians and an increase in the number of drug addiction treatment specialists in the state.
Several other recommendations involved law enforcement agencies and legal institutions.
Michigan is one of many states, that in recent years, has been struggling with increased rates of overdose from opioid painkillers and increased use of heroin. Twenty percent of unintentional fatal drug poisonings from 2009 to 2012 were definitively opioid-related, according to a report from the Michigan Department of Community Health (PDF).
Larry Wagenknecht, CEO of the Michigan Pharmacists Association and member of the task force, said it was important to develop regulations around the state's automated prescription service, called MAPS. The system is currently not mandated and has had technical issues in the past.
Recommendations for updating or replacing the system as well as requiring all licensed prescribers to register were key to the report, he said.
“Our members were pleased there were some new requirements for physicians,” he said.
The new or updated system must easily integrate into physician and pharmacist workflow and should not be onerous or disruptive, he said.
Dr. Pino Colone, chairman of the Michigan State Medical Society Task Force on Opioid Stewardship, said the recommendations are an important first step and physicians need to be a part of solving the problem.
Adequate and successful pain management is important for patients, but improving MAPS would also help with patient safety, he said.
Because physicians see so many patients in a day, it may help to allow a dedicated staff member of a practice to access MAPS, instead of only allowing physicians to use it, Colone said.
“It is onerous to check the MAPS program for every patient and it takes time and we have limited time with the patients,” he said.
Dr. John Pappas, an anesthesiologist with Beaumont Health and associate professor at Oakland University William Beaumont School of Medicine, said opioid addiction had reached a level of national crisis, as evidenced by new federal regulations President Barack Obama announced last week.
Pappas, who frequently speaks about responsible pain management, said he has helped design training programs for new doctors that emphasize other methods for easing pain before prescribing opioids.
Updating MAPS to include near real-time data and making it more user-friendly will be key to the success of the recommendations, he added.
And that will be important as the number of prescriptions for controlled substances has been increasing.
The number of prescriptions for controlled substances increased from 17 million in 2009 to 21 million in 2014, despite a slight drop in the state's population over that time, according to statistics from MAPS.
Obama's initiative focuses on more training for doctors who prescribe opioids and easing access to medication-assisted therapy for those who are addicted to prescription drugs or heroin.
Pappas said the crisis is affecting the entire nation.
“I think patients understand that,” he said. “I think physicians understand that. I think physicians are looking for guidance.”
