Study Finds Prescription-Monitoring Program Underutilized in Maine

Opioids prescribed to 22 percent of Mainers in 2014 -- enough to supply every man, woman and child in the state with a 16-day supply.

Husson University researcher: “The pharmacist is the 'last line of defense' for patient safety.”

BANGOR, MAINE – A team of researchers, including Husson University School of Pharmacy Associate Professor and Psychiatric Pharmacist Stephanie Nichols, PharmD, BCPS, BCPP published a study in the Journal of Studies on Alcohol and Drugs that has profound implications for the opioid addiction crisis in Maine.

According to the study, even though the misuse and diversion of prescription pain medications remains a major public health problem in Maine, a key program to help monitor and prevent opioid abuse is being underused.

Most U.S. states have established prescription-monitoring programs (PMPs) -- electronic databases that track prescriptions for opioids and other controlled substances. Healthcare providers can use the programs to identify possible cases of prescription drug misuse, and help patients get treatment for addiction if needed.

While Maine has had a PMP since 2004, Nichols' team found that in 2014, many pharmacists were
not using it. Of 275 pharmacists surveyed, only 56 percent said they were using the program.

Doctors and other healthcare providers use the system, but it’s still important for pharmacists to be linked in, too, according to Nichols.

"Often, the pharmacist is the 'last line of defense,' for patient safety" she said.

Based on the state's PMP, opioids were prescribed to 22 percent of Maine residents in 2014 -- enough to supply every man, woman and child in the state with a 16-day supply.

That figure is down slightly from 2010, Nichols said. "But it's still a very large number," she added.

Beside a PMP, Maine also has a diversion alert program that allows providers to see whether a patient has a history of drug-related arrests, according to Nichols. “We have resources to help tackle the opioid epidemic," she said, "but we're underusing them."

In an encouraging sign, though, prescriptions for oxycodone and hydrocodone were lower in 2014, while prescriptions for buprenorphine were up sharply. Buprenorphine is an opioid, but it's typically used to treat opioid addiction.

"I think that's a positive trend, because we interpret that as an increase in treatment of people with an Opioid Use Disorder," Nichols said.

Still, she added, more can be done. That includes getting healthcare providers and pharmacists on board with existing programs and increasing the accessibility and usability of said programs.

The study also revealed another troubling trend associated with opioid addiction in Maine.

In 2014, a high percentage of women in their 80s -- 38 percent -- had prescriptions for opioids. "That's very concerning," said Dr. Nichols. For one, she explained, elderly people have a higher rate of respiratory conditions, which makes them more susceptible to an accidental opioid overdose.

What's more, the study found, women in their 80s were also commonly prescribed sedatives known as benzodiazepines. “If one of those medications were combined with an opioid, that would also raise the risk of a potentially fatal overdose,” says Nichols.

Prescription opioids include medications like hydrocodone (Vicodin), oxycodone (OxyContin, Percocet), codeine, and morphine. According to the U.S. National Institute on Drug Abuse, an estimated 52 million Americans have ever abused a prescription drug -- and opioid painkillers top the list.

Members of Nichols team who participated in this study included Dr. Brian Piper. Piper was the lead investigator on the study. He is currently a visiting assistant professor of psychology and neuroscience at Bowdoin.

The co-authors of the study were Dr. Sarah Martin and Dr. Robert Baker. Sarah L. Martin, PhD, is an assistant professor while Robert P. Baker, PharmD, is a manager of quality assurance in experiential education and an associate professor of pharmacy practice. Both are faculty members at the Husson University School of Pharmacy.

Other researchers who participated in this study included: Kenneth L. McCall, PharmD, CGP, an associate professor and residency director at the University of New England; Clare E. Desrosiers, MSW, executive director for Diversion Alert, a program sponsored by the Substance Abuse Prevention Coalition in Aroostook County, Maine; John Lipovsky, past coordinator of the prescription monitoring program with the Maine Office of Substance Abuse and Mental Health Services; and Matthew A. Rodney, PharmD, a Husson University School of Pharmacy graduate.

Founded in 2006, the Husson University School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education (ACPE). The School graduated its first class with Doctorate of Pharmacy (PharmD) degrees in May 2013.

While Husson University prides itself as a teaching institution, the importance of faculty scholarship and research to contemporary pharmacy education is highly valued. The School of Pharmacy has been able to attract nationally renowned educators with expertise in alcohol research, wound healing, and national board certification in the specialty areas of pharmacotherapy.

For more than 100 years, Husson University has prepared future leaders to handle the challenges of tomorrow through innovative undergraduate and graduate degrees. With a commitment to delivering affordable classroom, online and experiential learning opportunities, Husson University has come to represent superior value in higher education. Our Bangor campus and off-campus satellite education centers in Southern Maine, Wells and Northern Maine provide advanced knowledge in business; health and education; pharmacy studies; science and humanities; as well as communication. In addition, Husson University has a robust adult learning program. For more information about educational opportunities that can lead to personal and professional success, visit Husson.edu.