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Harold Cordner, MD
The use of opioids to treat acute and chronic nonmalignant and malignant pain has steadily increased since the late 1990s. With this increase in opioid use, prescription opioid abuse increased to epidemic proportions. In 2012, an estimated 2.1 million Americans suffered through substance-abuse problems related to prescription opioid pain relievers. Florida was the epicenter of prescription-drug abuse, overdose deaths and "pill mills."
Since 2010, the state of Florida has drastically reduced the accidental deaths due to prescription opioid abuse through legislation, the enactment of the Prescription Drug Monitoring Program, the crackdown on pill mills and other means.
However, prescription-drug abuse still occurs. There still is a need to deter the misuse and abuse of prescription opioids by various methods of adulteration, commonly referred to as tampering. The preferred method of abusing opioids is to crush or chew the pill, and snort or inject the medicine to achieve a high similar to heroin. This increases the rate of absorption, leading to euphoria, but it can also cause toxicity, overdose and death.
Drug-overdose deaths — driven largely by overdose from prescription opioids and illicit drugs like heroin and illegally made fentanyl — are now the leading cause of injury death in the United States, surpassing motor vehicle crashes.
In response to the opioid-abuse epidemic, leaders of the U.S. Food and Drug Administration have called for a far-reaching action plan to reassess the agency's approach to opioid medications. The FDA has been diligently assessing and approving pain medications designed to minimize abuse. Many manufacturers offer various abuse-deterrent formulations and products that contain the active opioid, but cannot be crushed, chewed, snorted or injected.
These abuse-deterrent opioids make it difficult for abusers to alter the medicines to maximize the euphoric effects via rapid-delivery routes. Some abuse-deterrent formulations have physical and/or barrier technologies, which prevent the abuser from altering the formulation via crushing, snorting or chewing. Some have chemical compositions, which reduce the euphoric effects if adulterated. While these formulations cannot stop all misuse, diversion or abuse, they can reduce the likelihood of illicit use.
The Florida Legislature is currently considering two bills addressing the subject of abuse-deterrent opioids — Senate Bill 422 and House Bill 363. The bills provide that, with a limited number of exceptions, insurance policies that cover opioid medications cannot require prior authorization for abuse-deterrent versions of the medications.
While I believe these bills have limitations and may not do enough to mandate abuse-deterrent opioids are available to physicians and patients, I hope the Florida Legislature will approve SB 422 and HB 363, as this legislation will help to give physicians the ability to prescribe abuse-deterrent formulations when appropriate.
FSIPP President Harold L Dalton, DO in attendance.
DEERFIELD BEACH, Fla. —Fear of the DEA has been a recurring theme in the WESH 2 News ongoing investigation of Florida's prescription drug problem. Patients with real health issues are being denied the medication.
The DEA said it would answer those accusations at Florida's Board of Pharmacy hearing Monday.
"We don't want people to fear us, ...
FMA Snapshot - Congratulations Dr. Silverman
FMA President-Elect Alan Pillersdorf, M.D., attended the Broward County Medical Association Installation Gala on Saturday in Fort Lauderdale. From left to right are BCMA President Richard Steinman, M.D., BCMA President-Elect Sanford Silverman, M.D., and Dr. Pillersdorf.
Sanford Silverman, MD appears on The Usual Suspects televison show in Tallahasee discussing CRNAs.
Parts 3 & 4
- Ground zero has said to be in Florida and Dr. Silverman is fighting on the front lines against it.