[Pharmwaste] Overprescribing Documented, only 27% used

Motamedi, Saadi (DEP) saadi.motamedi at state.ma.us
Fri Nov 9 09:26:49 EST 2018


Not sure if you are aware but Massachusetts, in 2016, promulgated regulations which has limits on the prescription of certain opioid medications including patients requesting for a partially filled prescription.

https://www.mass.gov/news/update-for-prescribers-new-law-regarding-opioids

http://www.massmed.org/News-and-Publications/Vital-Signs/What-You-Must-Know-About--the-New-Opioid-Laws/#.W-WUU5NKi70

https://malegislature.gov/Bills/189/House/H4056

https://www.masslive.com/politics/index.ssf/2016/03/massachusetts_house_limits_siz.html


Thank you,
  _______________________________
Saadi Motamedi
Compliance and Enforcement
Bureau of Air and Waste
Massachusetts Department of Environmental Protection
Western Regional Office
436 Dwight Street, Springfield, MA 01103
Phone: 413/755-2131    Fax: 413/784-1149
E-Mail: Saadi.Motamedi at Mass.gov<mailto:Saadi.Motamedi at Mass.gov>

~The information transmitted is intended solely for the individual or entity to which it is addressed and may contain confidential and/or privileged material. If you are not the intended recipient, please do not retransmit or disseminate. If you have received this email in error please contact me and delete the material from your computer.

From: Pharmwaste <pharmwaste-bounces at lists.dep.state.fl.us> On Behalf Of Ed Gottlieb
Sent: Friday, November 9, 2018 8:54 AM
To: Carlos Chavez <cchavez at HWMA.net>; pharmwaste at lists.dep.state.fl.us
Subject: Re: [Pharmwaste] Overprescribing Documented, only 27% used


Thanks Carlos!



Alternately, if prescription renewal for controlled was easy, it could be written for "5 pills", with up to four renewals.


Ed Gottlieb
Chair, Tompkins County Coalition for Safe Medication Disposal
Industrial Pretreatment Coordinator
Ithaca Area Wastewater Treatment Facility
525 3rd Street
Ithaca, NY  14850
(607) 273-8381<tel:(607)%20273-8381>

________________________________
From: Carlos Chavez [cchavez at HWMA.net]
Sent: Thursday, November 08, 2018 5:23 PM
To: Ed Gottlieb; pharmwaste at lists.dep.state.fl.us<mailto:pharmwaste at lists.dep.state.fl.us>
Subject: RE: [Pharmwaste] Overprescribing Documented, only 27% used
Hi Ed,

I would add patient empowerment over their medication purchases.  Rather than prescriptions being written for set quantities such as "30 pills", prescriptions could be written as ranges up to set limits, such as "Up to 30 pills" and have the patient choose the quantity they want to receive which would then cause a pharmacy to charge a prorated price based on their chosen quantity.


Carlos

From: Ed Gottlieb <EGottlieb at cityofithaca.org<mailto:EGottlieb at cityofithaca.org>>
Sent: Thursday, November 08, 2018 6:04 AM
To: pharmwaste at lists.dep.state.fl.us<mailto:pharmwaste at lists.dep.state.fl.us>
Subject: [Pharmwaste] Overprescribing Documented, only 27% used




Medication take-back is one of many ways to help stop the opioid epidemic.  Unlike other approaches, it also addresses accidental poisonings and environmental contamination.



When asked about take-back, I say it is one of the easiest, and low cost, solutions to implement.  There are many other approaches that also need to be pursued, including:

Less over prescribing [see story below], alternatives to opioids, expanding treatment of opioid-use disorders<https://urldefense.proofpoint.com/v2/url?u=http-3A__scholar.google.com_scholar-5Furl-3Furl-3Dhttps-3A__cloudfront.escholarship.org_dist_prd_content_qt0kg4v8c8_qt0kg4v8c8.pdf-26hl-3Den-26sa-3DX-26scisig-3DAAGBfm2aTKZwDfxS1GYDv-5FqLecSeoTHhHQ-26nossl-3D1-26oi-3Dscholarr&d=DwMF-g&c=euGZstcaTDllvimEN8b7jXrwqOf-v5A_CdpgnVfiiMM&r=52UlWrWMYpEvPhUsE4m0-Q&m=z3H24qA9MzyFxThu4NMbpBWftt0R7cYoly9Ww7NeN5U&s=Co6Z037N6PbyCCYUGxlBWZEQv_5t23BN-4mgM6kKSe0&e=>, alternatives to incarceration, stricter enforcement (and more sever penalties) for deceptive marketing by drug makers, & ???  What would you add to this list?  Thanks!



https://jamanetwork.com/journals/jamasurgery/article-abstract/2712855?utm_source=STAT+Newsletters&utm_campaign=52db5b192a-MR_COPY_08&utm_medium=email&utm_term=0_8cab1d7961-52db5b192a-149620549<https://urldefense.proofpoint.com/v2/url?u=https-3A__jamanetwork.com_journals_jamasurgery_article-2Dabstract_2712855-3Futm-5Fsource-3DSTAT-26-2343-3BNewsletters-26amp-3Butm-5Fcampaign-3D52db5b192a-2DMR-5FCOPY-5F08-26amp-3Butm-5Fmedium-3Demail-26amp-3Butm-5Fterm-3D0-5F8cab1d7961-2D52db5b192a-2D149620549&d=DwQF-g&c=euGZstcaTDllvimEN8b7jXrwqOf-v5A_CdpgnVfiiMM&r=52UlWrWMYpEvPhUsE4m0-Q&m=z3H24qA9MzyFxThu4NMbpBWftt0R7cYoly9Ww7NeN5U&s=xDq-A6fuUnH8dFgzqR-4yv3SWZzjg76KLN7jjCeIEDs&e=>

Question  What factors are associated with opioid consumption after surgery?

Findings  In this population-based study of patients undergoing surgery in Michigan, 2392 patients used only 27% of the opioids prescribed to them. Prescription size had the strongest association with opioid consumption after surgery, with patients using an additional 5 pills for every 10 extra pills prescribed.

Meaning  Excessive opioid prescribing is associated with higher opioid consumption after surgery. Using patient-reported opioid consumption will improve postoperative opioid prescribing to better match patient opioid requirements.

Ed Gottlieb
Chair, Tompkins County Coalition for Safe Medication Disposal
Industrial Pretreatment Coordinator
Ithaca Area Wastewater Treatment Facility
525 3rd Street
Ithaca, NY  14850
(607) 273-8381<tel:(607)%20273-8381>

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