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"Drug and Narcotic Control"
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Buprenorphine Dispensing after Elimination of the Waiver Requirement
In the year after the elimination of a waiver requirement to prescribe buprenorphine, the number of prescribers increased above the anticipated value, but the number of persons who received the drug did not.
Journal Article
New psychoactive substances: challenges for drug surveillance, control, and public health responses
The rapid emergence since the mid-2000s of a large and diverse range of substances originally designed as legal alternatives to more established illicit drugs (pragmatically clustered and termed new psychoactive substances; [NPS]) has challenged traditional approaches to drug monitoring, surveillance, control, and public health responses. In this section of the Series, we describe the emergence of NPS and consider opportunities for strengthening the detection, identification, and responses to future substances of concern. First, we explore the definitional complexity of the term NPS. Second, we describe the origins and drivers surrounding NPS, including motivations for use. Third, we summarise evidence on NPS availability, use, and associated harms. Finally, we use NPS as a case example to explore challenges and opportunities for future drug monitoring, surveillance, control, and public health responses. We posit that the current means of responding to emerging substances might no longer be fit for purpose in a world in which different substances can be rapidly introduced, and where people who use drugs can change preferences on the basis of market availability.
Journal Article
State Legal Restrictions and Prescription-Opioid Use among Disabled Adults
In this analysis of Medicare data and a data set of state laws, adoption of legislation to restrict the prescribing and dispensing of opioid medications was not associated with reductions in potentially hazardous use of opioids among disabled Medicare beneficiaries.
States have responded to rising rates of prescription-opioid overdose by adopting laws that restrict the prescribing and dispensing of controlled substances. In 2010, after the adoption of many new controlled-substance restrictions, rates of prescription-opioid overdose dipped slightly before reaching a historic high in 2014.
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The relationship between legal restrictions and prescription-opioid use remains unclear, because previous research evaluated one or two laws, short time periods, or few states.
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Comprehensive national analyses of controlled-substance restrictions and prescription-opioid use do not yet exist.
Successful regulation of prescription opioids involves a difficult balance. Well-designed laws may reduce misuse and overdose. However, . . .
Journal Article
Community Pharmacies in Poland—The Journey from a Deregulated to a Strictly Regulated Market
Community pharmacies are the primary entities providing drugs to individual patients in Poland. The pharmacy market has been changing for many years due to significant changes in market regulations. These changes significantly affect the profitability of pharmacies, which may impact the quality of pharmacotherapy. The small number of pharmacies, which resulted from changes in the law in 2017, can influence the level of patient care. The article presents the community pharmacies market in Poland. Particular attention is paid to the legal regulations affecting community pharmacies and the impact of these regulations on the overall shape of the market. The Polish system’s specificity, including the pharmacy market indicators, has been compared with data from other European Union countries.
Journal Article
Neoliberal pharmaceutical science and the Chicago School of Economics
In recent years, science studies scholars have critically examined several methods used by the pharmaceutical industry to exert control over knowledge about drugs. Complementary literatures on 'medical neoliberalism' and 'neoliberal science' draw attention to the economic ideas justifying such methods of organizing knowledge, and in so doing suggest that neoliberal thinkers may play an important role in developing them. As yet, the nature of this role remains unexplored. Relying on heretofore-unexamined archival evidence, this article establishes a direct link between the Chicago School of Economics and the mobilization of the pharmaceutical industry in the 1970s. It argues that economists affiliated with the Chicago School of Economics sought to influence pharmaceutical policy and science and constructed institutions to do so. These institutions - most notably the Center for the Study of Drug Development - remain highly influential. This article contributes to a historical understanding of how neoliberal ideas came to assume prominence in pharmaceutical policy, the management of science, and scientific practice.
Journal Article
Prescription Drug Monitoring and Dispensing of Prescription Opioids
Objective. In the United States, per-capita opioid dispensing has increased concurrently with analgesic-related mortality and morbidity since the 1990s. To deter diversion and abuse of controlled substances, most states have implemented electronic prescription drug monitoring programs (PDMPs). We evaluated the impact of state PDMPs on opioid dispensing. Methods. We acquired data on opioids dispensed in a given quarter of the year for each state and the District of Columbia from 1999 to 2008 from the Automation of Reports and Consolidated Orders System and converted them to morphine milligram equivalents (MMEs). We used multivariable linear regression modeling with generalized estimating equations to assess the effect of state PDMPs on per-capita dispensing of MMEs. Results. The annual MMEs dispensed per capita increased progressively until 2007 before stabilizing. Adjusting for temporal trends and demographic characteristics, implementation of state PDMPs was associated with a 3% decrease in MMEs dispensed per capita (p= 0.68). The impact of PDMPs on MMEs dispensed per capita varied markedly by state, from a 66% decrease in Colorado to a 61% increase in Connecticut. Conclusions. Implementation of state PDMPs up to 2008 did not show a significant impact on per-capita opioids dispensed. To control the diversion and abuse of prescription drugs, state PDMPs may need to improve their usability, implement requirements for committee oversight of the PDMP, and increase data sharing with neighboring states.
Journal Article
Prescription Drug Monitoring Programs — Friend or Folly in Addressing the Opioid-Overdose Crisis?
Virtually every U.S. state has implemented a PDMP to address high-risk opioid-prescribing and opioid-seeking behaviors. Many stakeholders, however, have expressed doubts about their utility and concerns regarding their potential unintended consequences.
Journal Article