Identifying and Preventing Narcotic Abuse in Pain Management

There are definite indications for treating chronic pain at times with chronic narcotics. It's not an ideal situation, but they do have their place for effective pain management. One of the key aspects of preventing opiate abuse is being able to identify those who are either intentionally or unintentionally falling into a higher risk profile for medication abuse. Here are some considerations in identifying those individuals.

First it should be noted that individuals who are on opiate medications regularly cost the health care system about $23,000 annually. This figure increases by $3000 annually if the patient is noncompliant with their medications. That represents a 13% increase in healthcare costs due to a noncompliant patient.

Studies have shown that if a patient is unemployed there is a higher chance of noncompliance with narcotic prescription instructions. Previous drug abuse is another risk factor for noncompliance. At the beginning of care, pain management doctors will often have those being treated sign a pain management agreement laying out the rules to increase the rate of compliance. Most of the time these agreements include that the patient receive pain medications from only one doctor, only fill their prescriptions at one pharmacy, and notify the pain management doctor about any new medications being taken.

This is another method of identifying compliance is to perform urine or saliva samples for drug testing on patients.

One way to potentially prevent narcotic abuse and pain management is through education. Over 20,000 fatal overdoses occur annually due to narcotics, and patients need to know this. Being on significantly high doses of opiate medications can lead to substantial complications along with making that individual a poor candidate for surgery.

Educating individuals on the reasons behind a drug test can make them more comfortable in knowing that it is not simply a method to catch those cheating. There is significant data now to show that even the best pain management doctors are often wrong almost a third of the time on which patients are abusing drugs. A lot of doctors think they know their patients well and are able to delineate between who would abuse narcotics or diverged opiates as opposed to compliant patients. The data shows clearly otherwise.

Once there is sufficient suspicion to assume narcotic abuse in patients, there should be a mechanism in place to get that patient help and prevent the abuse from going down the road towards a fatal overdose. Resources on available substance abuse programs and counseling will be vital to prevent this spiral of abuse.

The bottom line with identifying and preventing narcotic abuse is vigilance. Getting to know patients, having them comply with the pain management agreements, drug testing patients, and checking the pharmacy board website to ensure compliance at the pharmacy are excellent places to start.