Statewide reporting system effective in addressing prescription drug overdose epidemic

March 20, 2013
A statewide system designed to curb the number of deaths resulting from prescription drug overdose is underused but effective, according to a new study at the University of North Carolina at Chapel Hill. The findings, released during National Poisoning Prevention Week (March 18-23), have prompted discussion on how to promote the system’s use and strengthen its impact.
 
Mariana Garrettson

Mariana Garrettson

“Prescription drug overdose kills an average of three people per day in North Carolina,” said Mariana Garrettson, MPH, who led the study at UNC Injury Prevention Research Center (IPRC). “The system is an incredibly important tool to identify people who abuse and misuse prescription drugs as we attempt to respond to this growing epidemic.”

 
Garrettson is program director of evaluation and dissemination at the IPRC and adjunct instructor of health behavior at the Gillings School of Global Public Health.
 
In 2005, the North Carolina legislature passed a law to establish the statewide system, known as the North Carolina Controlled Substances Reporting System (CSRS). The purpose of the CSRS is to collect data on prescription drugs as they are dispensed and to make these data available for various uses, such as patient care, public health surveillance and law enforcement. Pharmacists and physicians are encouraged to use this tool to identify patients who abuse prescription drugs and increase their referral to treatment.
 
However, of the 34,000 physicians who are registered with the Drug Enforcement Agency to prescribe controlled substances, only one-third have registered with the CSRS; fewer than half of those registered actually used it in the last six months of 2011.
 
At the same time, the number of patients with the most severe drug-seeking behaviors – those who used 10 prescribers and 10 pharmacists within six months – decreased substantially from 217 in 2008 to 115 in 2012.
 
During this same period, patients with unusual prescription patterns also saw positive changes. The average number of prescriptions these patients received every six months decreased, whereas the average for all other patients increased. Patients with risky prescription patterns whose providers used the reporting system were also five times as likely to receive treatment for opioid addiction as similar patients whose providers did not use the system.
 
Garrettson points out that the study also should reduce concerns that the reporting system has resulted in providers prescribing fewer controlled substances to patients who genuinely need them.
 
“There is every indication that this system is working as intended,” Garrettson said. “We just have to figure out how to get more providers and pharmacists on board. Legislative changes, like having pharmacies report into the CSRS within 24 hours instead of weekly, giving providers the authority to delegate to key office staff responsibility to look up patient records, and allowing the CSRS to send unsolicited reports of unusual patient prescription activity to their providers and pharmacists, could greatly strengthen the system and increase its ease of use for providers.”

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Gillings School of Global Public Health contact: David Pesci, director of communications, (919) 962-2600 or dpesci@unc.edu.