Fine seeking improved painkiller management

The R.I. Department of Health is undertaking a new education program for licensed physicians and pharmacists to seek to better manage prescription painkillers, according to agency Director Michael Fine.
The outreach effort is in direct response to new research findings by Traci Craig Green, assistant professor of medicine and community health at the Warren Alpert School of Medicine of Brown University, that linked the rise in deaths from accidental overdoses in Rhode Island with prescription painkillers and their interaction with anti-depressants and sleep aids. Results from Green’s research – a systematic review of medical-examiner case files from accidental drug overdoses in Rhode Island and Connecticut – showed a disturbing trend emerging: the demographic most at risk for death by accidental overdose are women and men between the ages of 35 and 54 who are also being treated with anti-depressant prescription drugs and sleeping aids. The geographic trend is that these deaths occur more frequently in suburban, small-town settings than in urban areas.
When you combine anti-depressants with prescription opioids – the technical name for synthetic opium products such as dilaudid, oxycodone and oxycontin, Green explained, “it increases the opioids’ effect, suppressing a person’s breathing, and accidental overdoses may occur,” she said.
Fine met recently with Green to discuss her research findings and decided to take action.
As a result, Fine told Providence Business News, he noted in a newsletter to all licensed pharmacists and physicians in Rhode Island on Aug. 22, the need to better manage prescriptions for painkillers. “While provider education doesn’t sit squarely in our bailiwick, I will be using the bully pulpit,” he told PBN. In turn, he continued, the agency will be working with a couple a different groups more focused on provider education. “I am identifying it … as a public-health issue,” Fine said. While addiction is not part of the broad umbrella of responsibilities at the Department of Health, Fine continued, “tracking the impact of disability and disease is in our [purview]. When you look at the years of potential life loss, it’s a very significant cause of cost and morbidity,” he said.
“This electronic newsletter marks a new orientation, a new attitude and some new directions,” Fine wrote. “Expect to see us direct your attention to prescription drug overdoses and to prescription drug abuse, which is causing significant injuries to Rhode Islanders.”
The e-newsletter also said that each Rhode Island physician with a controlled-substances registration will receive a copy of a book, “Responsible Opioid Prescribing,” by Scott Fishman.
When asked to measure the importance of the public-health issue, using the scale that physicians use to diagnose pain, from one to 10, Fine said: “I think I would put it about a seven or an eight, maybe greater. The risk from prescription medications is a real thing.”
In addition, Fine said that Rhode Island will be strengthening its prescription monitoring program. “We’re in a contracting process that will make it much more usable by physicians and pharmacists, expanding it so that both physicians and pharmacists will not only to be able to consult but actively query the [database].” &#8226