National Groups Work to Curb Abuse

By Karmen Hanson

The Internet is a key source for legitimate and fraudulent prescription purchases.

Numerous studies have found a proliferation of online pharmacies that don’t require a prescription from the patient’s doctor. Some use an “in-house” diagnosis and prescribing procedure that allows easy access to powerful medications. Other unregulated, so-called pharmacies may dispense illegally manufactured and counterfeit reproductions of medications that contain none of the active ingredients. Counterfeit products are potentially dangerous for legitimate and fraudulent purchases alike.

The National Boards of Pharmacy uses an accreditation process for online pharmacies called Verified Internet Pharmacy Practice Sites or VIPPS to combat prescription drug abuse.

Facilities must meet a strict set of guidelines to earn the use of the logo on their website. Eighteen pharmacies, including major chains, have received verified status. A few states also require a separate licensing category for online and Internet pharmacies.

Companies that make products prone to abuse have taken steps to ensure their products are handled and dispensed safely. Purdue Pharma, for example, the maker of the pain-killer OxyContin, uses numerous efforts to educate prescribers, law enforcement and the general public about the safe and legal use of their products.

And that’s what they should be doing, says Connecticut’s Attorney General Richard Blumenthal.

“Purdue Pharma has a moral, if not legal, obligation to take effective steps now that address addiction and abuse even as it works to reformulate the drug,” Blumenthal said.

Alan Must, vice president of State Government and Legislative Affairs at Purdue Pharma, says the company has been working for the last nine years to support prescription monitoring programs as one way to help reduce abuse.

“Reducing the abuse of prescription medications,” he says, “ will take the combined and coordinated efforts of healthcare professionals, law enforcement, government agencies and local communities.”

Examples of Purdue Pharma’s outreach include:

• Partnership for a Drug Free America: Effort includes a public service advertising campaign, community anti-drug abuse grants, and an early detection and intervention resource.
• Working with Law Enforcement: They provide educational brochures and videos for law enforcement and health care professionals, combat pharmacy-related crimes through resources like a pharmacy security checklist, and promote steps to protect medicines in households.
• Monitoring and Protecting the Supply Chain: Radio Frequency Identification tags are incorporated on bottles, packages and pallets to enable tracking of product through the supply chain. This initiative can help detect diversion and counterfeit products. Purdue also monitors customer orders for potentially suspicious activities including frequent orders of same product from multiple distributors on the same day.
• Working with Managed Care Organizations: Purdue software program allows managed care organizations to review member claims data to identify those that may warrant investigation, including multiple prescribers for an opioid analgesic, overlapping opioid analgesic therapies and multiple pharmacies filling opioid analgesic prescriptions.
• Developing New Formulations of Medications: Purdue is developing new forms of pain medications that are intended to provide safe and effective pain relief to patients while being less desirable to drug abusers.
• State Prescription Monitoring Programs: Purdue has worked in numerous states to support the development of Prescription Drug Monitoring Program (PMPs). Properly designed PMPs can help healthcare professionals and law enforcement detect and prevent doctor shopping. To date, 39 states have enacted PMP legislation.
• Healthcare Professional Education: Purdue supports independent non-promotional education programs with grants and materials on understanding the importance of appropriate pain care, properly assessing and treating of patients with pain, recognizing and addressing methods used to unlawfully obtain and / or abuse controlled substance medications and appropriate documentation of pain care.

Pricara, a division of Ortho-McNeil-Janssen Pharmaceuticals, has a program called Smart Moves, Smart Choices to educate middle and high school students about the serious risks of abusing prescription medicines.

Endo Pharmaceuticals Medical Affairs staff works with health professionals to provide education and resources about preventing prescription drug abuse.

With all of the resources available, states have numerous policy options and may work closely with manufacturers and health care professionals to ensure safe and appropriate access to all prescription medicines.