Drug companies have tried odd methods to reduce opioid abuse, like making pills rubber-like, so they are harder to crush and then inject or inhale. Others have added components that produce reactions like itching or flushing if the pill is altered. Most recently Embeda, called an “abuse-deterrent opioid,” has an outer layer that if crushed releases a drug that counteracts the effect of the inner part of the pill which contains the pain reliever. These methods, while clever, have not worked as abusers always seem to find a way around them. After all, an addict is by definition highly motivated. And, these approaches don't address the underlying problems. They address how the pill is used by an abuser/addict, rather than trying to prevent addiction risk in the first place.
Another approach involves registries. Almost all states are working with variable success to establish on-line monitoring systems; i.e., databases that doctors and pharmacists can check to see if a patient has been doctor shopping or already has multiple prescriptions at different drug stores. While this is seen as a powerful tool in places like Massachusetts, it has proved too cumbersome to the point where it's not really useable or accurate in every-day use. It’s also backwards, as it is designed to intervene after addiction develops.
Dr. Steven Passki, a clinical psychologist with the Memorial Sloan-Kettering Cancer Center in Manhattan advises–
Another approach involves registries. Almost all states are working with variable success to establish on-line monitoring systems; i.e., databases that doctors and pharmacists can check to see if a patient has been doctor shopping or already has multiple prescriptions at different drug stores. While this is seen as a powerful tool in places like Massachusetts, it has proved too cumbersome to the point where it's not really useable or accurate in every-day use. It’s also backwards, as it is designed to intervene after addiction develops.
Dr. Steven Passki, a clinical psychologist with the Memorial Sloan-Kettering Cancer Center in Manhattan advises–
A more complete strategy to combat opioid abuse … would involve asking busy primary care doctors to routinely assess how vulnerable to addiction a patient might be..."
NYT, N. Singer, Taking the Fun Out of Popping Pain Pills
In other words, the assessment of new and existing pain patients’ risk for addiction should be part of any strategy to prevent addiction before prescribing medications. But, such as assessment has to be easily performed, and reimbursed, before we ask a busy practitioner to do this routinely. TestSTAT created the PME to meet these needs.