A Systematic Review of the Prevention and Treatment of Prescription Drug Misuse

Abstract

There is little empirical evidence for the prevention and treatment of PDM and the majority of published guidelines and studies focus on prescription opioids. Important limitations include the lack of information about appropriately identifying and managing persons at risk for PDM. More research is needed to identify and recommend effective mechanisms for the prevention and treatment of PDM.

Opioid Use Patterns Among Active Duty Service Members and Civilians: 2006–2014

“…During this period of observation, 14 separate directives or policies were implemented in the DoD involving the prevention or treatment of prescription drug misuse. 9 9 Furthermore, in 2010, the Army's Pain Management Task Force developed 109 recommendations and clinical guidelines geared toward multimodal pain management (e.g., chronic opioid therapy, low back pain, and postoperative pain). 10 This led to the implementation of the DoD's comprehensive policy on pain management in March 2011.…”

“…8 Between 2006 and 2014, over 14 directives were created within the Department of Defense (DoD) related to safe opioid prescribing and appropriate pain management. 9 In addition, the Army's Pain Management Task Force developed 109 pain-related recommendations that included guidance on opioid prescribing and therapy. 10 Given changes in MHS policies regarding opioid use over the past decade and the structure of the military medical systemwhich may make it uniquely responsive to policy shifts compared with civilian medical systemsopioid prescribing patterns in recent years may be quite different in the military and civilian sectors.…”

What factors contributed to the misconduct of health practitioners? An analysis of Australian cases involving the diversion and supply of pharmaceutical drugs for non‐medical use between 2010 and 2016

“…The liberal prescribing practices of ‘script doctors’ in pain clinics or ‘pill mills’ in USA, is attributed to the profitability of the medications and pressure from patients . The challenges for HPs in identifying patients at‐risk of diversion and negotiating with ‘drug‐seekers’ , as well as increases in prescribing rates , have provided the basis for the widespread implementation of Prescription Monitoring Programs (or real‐time prescription monitoring/tracking) in the USA . Other jurisdictions have begun to follow suit, including Australia .…”

Preventing, Identifying, and Treating Prescription Drug Misuse Among Active-Duty Service Members

“…Evidence-based interventions and treatments for preventing and treating PDM are few (Blanchard et al, 2016), but there is some evidence supporting the use of screening tools to assess the potential for misuse, as well as behavioral and pharmacological treatments for opioid dependence. To assess the implementation of DoD policies and CPGs specific to PDM and to learn about innovative practices, as well as implementation barriers across the service branches, we conducted individual face-to-face interviews with 66 health and behavioral health providers at nine MTFs across three regions between July and November 2014.…”

“…In this chapter, we describe a comprehensive literature review that we conducted to help inform the military about the current evidence base for identifying and treating PDM (see Blanchard et al, 2016). The goal of this review was to identify evidence-based practices for the prevention, identification, and treatment of PDM, specifically to help inform future DoD efforts.…”