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    Study: Many opioid users are taking Rx drugs in potentially harmful combinations; education needed

    A majority of opioid users are taking the painkillers concurrently with other prescription drugs, according to a report from Express Scripts that analyzed US opioid trends.

    The Express Scripts Lab opioid study findings indicated that 58.5% of patients using prescription opiate painkillers were taking them with other prescription medications, in combinations that posed “potentially serious safety risks.” The combinations included opioids with benzodiazepines (29.2%), muscle relaxants (28.3%) or all 3 medications (8.0%); and 27.5% were taking 2 or more prescription opioids concurrently. Among the patients combining medications, 66.6% obtained prescriptions from two or more physicians, and 39.8% filled their prescriptions at 2 or more pharmacies.

    Despite risks in elderly benzodiazepine use increases with age

    According to the Express Scripts report, prescription opioids, benzodiazepines and muscle relaxants all have a sedative effect; combining these medications can magnify that effect and slow down the respiratory system, with potentially fatal consequences. Government statistics reveal that opioids were responsible for 75.2% of all pharmaceutical overdose deaths; and in deaths involving multiple prescription drugs, the combination of opioid analgesics and benzodiazepines accounted for 30.7% of deaths.

    Naloxone price increases may threaten public safety

    To combat substance abuse involving prescription drugs, 49 states—excluding Missouri—have implemented prescription drug monitoring programs (PDMPs) that use electronic databases to track the dispensation of controlled substances. However, PDMPs are not necessarily mandated or enforced in all states; and there are indications that some patients attempt to circumvent these programs by filling prescriptions out of state. An Express Scripts analysis found that “residents from seven neighboring states filled opiate prescriptions in Missouri as much as four times more often than residents in Missouri filled opioid prescriptions out of state.”



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