...This will not only relieve physicians from the fear of giving controlled substances to the wrong patients for the wrong reasons, but also it will improve patient access with the patient obtaining the proper medication...


Deja Vu
All the statistics continue to show that prescription drug abuse is escalating with increasing emergency department visits and unintentional deaths due to prescription controlled substances.

  • Americans, constituting only 4.6% of the world's population, consume 80% of the global opioid supply, and 99% of the global hydrocodone supply, as well as two thirds of the world's illegal drugs.

  • It has been shown that 80% of America's high school students, or 11 million teens, and 44% of middle school students, or 5 million teens, have personally witnessed, on the grounds of their schools: illegal drug use, illegal drug dealing, illegal drug possession, and other activities related to drug abuse.

  • The results of the 2008 National Survey on Drug Use and Health showed that 6.9 million or 2.8% of all persons aged 12 or older had used prescription type psychotherapeutic drugs nonmedically in the past month.

  • In 2008, 15.166 million, or 6.1% of the population, had used prescription psychotherapeutic drugs nonmedically in the past year, and 20.8%, or almost 51.97 million, had used them during their lifetime.

  • Since 1999, abuse, misuse, and overdose of prescription drugs have significantly increased. Each year more than 20,000 persons in the United States die from drug overdose. Those with the highest rates are adults age 35 to 44 and persons living in the South and West regions.

Controlled Substance Abuse

  • Opioids are used extensively despite a lack of evidence of their effectiveness in improving pain or functional status with potential side effects of hyperalgesia, negative hormonal and immune effects, addiction and abuse.

  • The multiple reasons for continued escalation of prescription drug abuse and overuse are lack of education among all segments of society including physicians, pharmacists, and the public; ineffective and incoherent prescription monitoring programs with a lack of funding for a national prescription monitoring program such as NASPER; and a reactive approach on behalf of numerous agencies.

Progress with NASPER

  • NASPER was signed into law on August 11, 2005, making it the only statutorily authorized program to assist states in combating prescription drug abuse of controlled substances through a prescription monitoring program (PDMP).

  • NASPER fosters interstate communication by providing grants to set up or improve state systems that meet basic standards of information collection and privacy protections that will make it easier for states to share information. This will enable authorities to identify prescription drug abusers as well as the "problem doctors" who betray the high ethical standards of their profession by over or incorrectly prescribing prescription drugs.

Present Status

  • Since the implementation of NASPER, a total of 35 states (maroon) have operational programs. And 6 states (blue) have enacted such programs (Fig. 4). The states without a program (white) include Montana, Nebraska, Maryland, New Hampshire. Missouri, Arkansas and Georgia. Delaware (yellow) has legislation pending. Data as of May 28, 2010.

  • In 2009, grants were awarded to multiple states (13) including Alabama, California, Connecticut, Illinois, Indiana, Kansas, Kentucky, Maine, Michigan, Mississippi, Nevada, New York, and Ohio.

  • Thus far, only 2 states (Kentucky and Connecticut) are attempting interoperability among the states.

  • NASPER is the only solution which will assist physicians, establish minimum standards for state PDMPs, and, ultimately, reduce drug abuse substantially (by at least 20% or more).

Solutions to the Drug Abuse Epidemic
A revised national drug control strategy with a 3-pronged approach is essential in combating the epidemic of prescription drug abuse with:

  • Immediate implementation of NASPER with enhancements

  • Widespread educational programs for physicians, pharmacists, and the general public emphasizing the deleterious effects of controlled substance use and abuse.

  • Implementation of the Synthetic Drug Control Strategy along with multiple other programs.

NASPER Reauthorization Act of 2010

  • A bipartisan bill is prepared to be introduced in the House of Representatives and the Senate for funding.
    • This bill is requesting authorization of appropriation to carry out $15 million for fiscal year 2011 and $10 million for each fiscal year 2012-2015.

ASIPP's Concerns and Recommendations:

  • As Congress moves forward, ASIPP strongly urges support of the reauthorization bill, along with funding for NASPER, the only authorized prescription drug monitoring program.
    • Fragmented funding of multiple unauthorized programs will only create confusion among states applying for funding, as well as both DOJ and HHS as they try to administer similar programs.

  • After appropriate passage through both chambers of Congress and signing by the President, NASPER needs to be funded at the full authorized amount of $15 million for 2011 and $10 million each year from 2012 to 2015.

For more information, please contact the ASIPP Government Affairs Counsel Tim Hutchinson ([email protected]) or Randi Hutchinson at Dickstein Shapiro Morin & Oshinsky, LLP at (202 955-6600 or [email protected])

American Society of Interventional Pain Physicians
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