Prescriber Self-Lookup Prescribers may also perform self-lookup reports. These reports may indicate potential cases of prescription fraud such as stolen prescription pads or phoned-in prescriptions not authorized by the
prescriber. It also provides a “snapshot” regarding the prescribers typical CS prescribing habits, and their patient population. 41
Case study 1 Mr. Connors, 54, has chronic neck pain for which he is prescribed short-acting 10 mg hydrocodone/ACET to take as-needed up to 4 per day. He does not take this medication daily but only on days when the pain spikes to 7/10 at rest, usually after exertion such as weeding his flower bed or taking a bike ride. He has always had consistent UDTs and PDMP checks, and the hydrocodone prescription helps him meet his goals of an active life. He drinks 2 beers several evenings a week and has no other history of or current substance use. He is treated for depression and has been stable on his escitalopram dose for years. His HCP and he have discussed the wisdom of limiting alcohol use with his current medications, and he has promised to try. While mowing his lawn one weekend, he strains his neck more than usual and is in significant pain that is constant, throbbing, and intense (9/10). He ices the area and takes 800 mg ibuprofen but finds the pain is still so intense he cannot sleep that night. His grown daughter offers him one of her alprazolam 1 mg, and he accepts so that he can sleep.. 1. Consider what would be the responsibility of the prescriber of CS in such a scenario. Consider the components of the treatment agreement previously assigned. How would one appropriately counsel and follow-up with the patient? _______________________________________________________________________________________________ _______________________________________________________________________________________________ DEPRESSANTS AND SEDATIVE-HYPNOTICS: BENZODIAZEPINES AND BARBITURATES The class of depressants includes many widely misused zaleplon, and zopiclone were (together with opioids) the most dispensed categories of CS in the United States (Figure 2). 4 Figure 2. Trends for Most Commonly Dispensed Categories of Controlled Substances in US Commercially-Insured Adults (January 2004 to June 2019)* medications. Furthermore, from 2004 to 2019, benzodiazepines and sleep medications zolpidem,
Six most commonly dispensed categories as of January 2019-June 2019 are presented: Depressants (schedule IV) contained benzodiazepines and sleep medications zaleplon, zolpidem, and zopiclone Depressants (Schedule V) contained brivaracetam, ezogabine, lacosamide, and pregabalin Opioids (Schedule III) contained codeine ≤90 mg per dosage, morphine ≤50 mg/100 mL or 100 g, both in a combination with another non-opioid ingredient, and buprenorphine Stimulants (Schedule II) contained amphetamine, methamphetamine, methylphenidate, lisdexamfetamine, and dextroamphetamine *Based on de-identified longitudinal claims data on beneficiaries of a large US employer-sponsored commercial health insurance provider and covers approximately 9 million individuals ages 19 to 64 years in any given month across all 50 states.
Book Code: TN24CME
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