In early October, the Office of National Drug Control Policy (ONDCP) and the National Institute on Drug Abuse (NIDA) launched a new online learning tool, which will provide training for healthcare providers on proper prescribing and patient management practices for patients on opioid analgesics (painkillers). The new tools include continuing medical education (CME) modules.
The launch of the tool builds upon previously announced Administration efforts to address the nation’s prescription drug abuse epidemic through a balanced public health and safety approach and support the Administration’s goal of reducing the misuse of prescription drug abuse by 15 percent by 2015.
Back in April of 2011, the White House unveiled a multi-agency plan aimed at reducing the “epidemic” of prescription drug abuse in the U.S.—including an FDA-backed education program that zeros-in on reducing the misuse and misprescribing of opioids. The action plan provides a national framework for reducing prescription drug diversion and abuse by supporting education for patients and healthcare providers, recommending more convenient and environmentally responsible disposal methods to remove unused medications from the home, supporting the expansion of state-based prescription drug monitoring programs, and reducing the prevalence of pill mills and doctor shopping through enforcement efforts.
More recently, the Food and Drug Administration (FDA) approved a final, class-wide Risk Evaluation and Mitigation Strategy (REMS) for long-acting and extended release opioids. According to what we can figure out, this program may not meet the FDA REMS blueprint requirement.
The new training materials, which include video vignettes modeling doctor patient conversations on the safe and effective use of opioid pain medications, are part of NIDA’s NIDAMED initiative, created to help physicians, medical interns and residents, and other clinicians understand and address the complex problem of prescription drug abuse. In addition to providing more accessible and self-guided information for healthcare providers, the training modules will also provide an opportunity for healthcare professionals to earn continuing medical education (CME) credits.
“It’s no coincidence that our strategy to address our nation’s prescription drug abuse epidemic begins with education,” said Gil Kerlikowske, Director of National Drug Control Policy. “All of us – parents, patients, and prescribers – have a shared responsibility to learn more about this challenge and act to save lives. Prescribers in particular play a critical role in this national effort and I strongly encourage them to take advantage of this training to ensure the safe and appropriate use of painkillers.”
“Physicians can be the first line of defense against prescription drug abuse by knowing how to prescribe opioid pain medications safely and effectively,” said NIDA Director Nora D. Volkow, M.D. “These CME courses provide practical guidance for clinicians in screening their pain patients for risk factors before prescribing. They also help medical professionals identify when patients are abusing their medications, using videos that model effective communication about sensitive issues, without losing sight of addressing pain.”
The training materials, funded by ONDCP, will include two online CME modules employing a “test-and-teach” model of instruction. During the first year, the training modules will reside on the Medscape Website for CME credit. The modules are also available on the NIDA Website where they can be adapted for use in the syllabi of academic medical schools.
According to data from the National Survey on Drug Use and Health (NSDUH) released last week, the number of young adults (people aged 18 to 25) who used prescription drugs for non-medical purposes in the past month declined 14 percent — from 2 million in 2010 to 1.7 million in 2011. However, the Centers for Disease Control and Prevention (CDC) still classifies prescription drug abuse as an epidemic, with roughly 100 people dying each day from drug overdoses, driven primarily by prescription drugs.
The number of prescriptions filled for opioid pain relievers has increased dramatically in recent years. From 1997 to 2007, the milligram per person use of prescription opioids in the U.S. increased from 74 milligrams to 369 milligrams, an increase of 402 percent. In 2000, retail pharmacies dispensed 174 million prescriptions for opioids; by 2009, 257 million prescriptions were dispensed, an increase of 48 percent. Further, opiate overdoses, once almost always due to heroin use, are now increasingly due to abuse of prescription painkillers.
We are hopeful that this educational initiative will make a difference and help providers make better choices in the treatment of pain. This educational initiative is somewhat of a missed opportunity, had the course been designed to meet the FDA Pain REMS blue print along with the NIDA and ONDCP requirements prescribers could perhaps have completed two activities at once.