Battling an unprecedented epidemicOver 15 million Americans misuse prescription drugs1

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Prescription Drug Monitoring

It’s a startling statistic. An estimated 1 person in 20 uses prescription drugs for “non-medical reasons.”2 Not only do these patients put themselves at grave risk, they also jeopardize any healthcare professional or practice that happens to prescribe them medication.

It’s important to understand the root causes of prescription medication misuse and the implications for your patients and practice. Only then can you take steps to ensure a safer environment for all.

Protect your patients from medication misuse

4.8%4.0% 3.1% 0.4%

Prescribed legally, then passed alongAmong people who misuse medication, nearly two-thirds take drugs prescribed for someone else.

Friend or relative

One doctor

Drug dealer

Other

Multiple doctors

Internet

65.9%22.1%

The many ways patients can misuse medicationIn a recent study, only 46% of patient test results were consistent with their prescriptions. The rest took medications that were different than or additional to those prescribed—or didn’t take their medication at all.

Possible inconsistencies may be attributed to a number of factors, including patients who:

• Don’t follow prescription instructions

• Underestimate the addictiveness of pain medication and other controlled substances

• Assume prescriptions are safe under all circumstances

• Share prescription drugs with friends or family

• Allow other people access to medications by failing to secure them

• Forget to notify their doctor of prescriptions from other healthcare providers

• Increase dosage without a physician’s approval

Prescribing for 2Prescribing to women of reproductive age requires special attention, especially given that nearly half of all pregnancies are unintended.3

• Opioid use during pregnancy can result in Neonatal Abstinence Syndrome (NAS)

• Intrauterine exposure to stimulants (i.e., cocaine, methamphetamines) is associated with fetal growth restriction and adverse effects on infant neurobehavior4

• The risk of stillbirth is 2 to 3 times greater in women who smoke tobacco or marijuana, take prescription pain relievers, or use illegal drugs during pregnancy5

54%46%

Consistent Inconsistent

More than half of patients in 1 study had test results inconsistent with their prescriptions.

Patient test results

Cases of NAS grew by about

300%in the U.S. 2000-20096

Every practice needs a process to monitor controlled medication useImplementing a prescription drug monitoring process can:

• Protect your practice and patients

• Improve communication between clinicians and patients about the risks and benefits of prescription drug therapy

• Increase the safety and effectiveness of drug treatments

• Reduce the risks associated with long-term prescription drug therapy, including substance misuse disorder and overdose7

Paying a terrible pricePoisoning is the No. 1 cause of injury death in the U.S. The overwhelming majority of those deaths involve drug poisoning overdose—47,055 in 2014 alone.8*

• Since 2000, the drug overdose death rate more than doubled, from 6.2 per 100,000 persons to 14.78

• The death rate involving opioid analgesics nearly quadrupled since 2000, from 1.5 per 100,000 in 2000 to 5.9 in 20148

• 40% of overdose deaths in 2014 involved opioid analgesics8

• Deaths from prescription painkiller overdoses among women have increased more than 400% since 1999, compared to 265% among men6

Source: CDC/NCHS, National Vital Statistic System Mortality file. 2000-2014

02000

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n

2002 2004 2006 2008 2010 2012 2014

2

4

6

8

10

12

14

16

All drug overdose deaths

Drug overdose deaths involving opioids

Drug overdose and opioid death rates: United States, 2000-2014

*Age-adjusted rate

Take steps to manage your risk With opioid-related deaths skyrocketing, the Centers for Disease Control and Prevention (CDC) recently issued guidelines for prescribing opioids for chronic pain in a primary care setting.7 Below is a partial list of clinical reminders and recommendations.

• Evaluate the patient for known risk factors such as illegal drug use, history of substance use disorder, or mental health conditions

• Check patients against state prescription drug monitoring program (PDMP) data for high dosages and prescriptions from other providers

• Conduct urine drug testing before starting opioid therapy and continue testing periodically to identify prescribed drugs and undisclosed use

• Avoid concurrent benzodiazepine and opioid prescribing whenever possible

• Refer patient for treatment of opioid use disorder, if needed

• Follow local regulations for managing chronic pain patients taking opioids

• Document your monitoring plans and patient encounters

Rely on urine drug testing to help monitor complianceObjective laboratory results can help identify:

• Noncompliance, drug substitution, or supplementation

• Concomitant use of illegal substances

• Potential drug interactions

• Adherence to pain therapies

Get all the drug testing you need from Quest Diagnostics®

Quest Diagnostics helps you protect your practice and patients with state-of-the-art testing, including an extensive menu for prescription pain medications, other controlled medications, illicit drugs, and designer drugs. With fast turnaround and results confirmation, Quest provides the most trusted and reliable drug testing available today. Whether you are starting a drug testing program or upgrading an existing one, Quest has the urine and oral fluid drug analysis you need.

Our menu covers the following drugs and their metabolites:*

Alcohol metabolites Amphetamines Barbiturates Benzodiazepines Buprenorphine** Carisoprodol Cocaine

Eszopiclone Fentanyl Gabapentin Heroin metabolite Marijuana MDMA/MDA Methadone

Methylphenidate Meperidine Naltrexone Opiates Oxycodone Phencyclidine Pregabalin

Synthetic/designer drugs Tapentadol Tramadol Tricyclic antidepressants Zolpidem

* Partial list only. Ask your Quest Diagnostics sales representative for the most current listing.

** Buprenorphine available with Naloxone.

Easily interpret results with our medMATCH® report and Interactive Insights™

SMITH, JOHN M.D.HORIZONS HEALTH CENTER189 GREEN STBOSTON, MA 02210

medMATCH

For assistance with interpreting Prescription Drug Testing Results, please contact a Quest Diagnostics Toxicology Specialist at 1.877.40.RX TOX (1.877.407.9869), M–F, 8am to 6pm EST.

Easy-to-read-and-interpret medMATCH reports compliance at a glance

Longitudinal reporting tracks patient results over time

Results that do not match prescribed medications are marked “Inconsistent”

Put our reputation for reliability, commitment, and excellence to work for youEntrust all your testing to Quest Diagnostics. We’re an industry leader with an unparalleled reputation, decades in the making, for reliability and commitment to service.

Broad health plan coverage makes testing more accessible and can encourage adherence.

Expansive network of 2,200 Patient Service Centers makes it easier for patients to follow through with testing.

Diverse testing for diverse needs with our comprehensive menu of tests—from routine to specialized—which was built with the varied needs of you and your patients in mind.

Patient assistance program ensures that uninsured patients receive care, with each case handled personally.

Care360® Labs & Meds ensures that lab tests can be ordered, received, accessed, and shared conveniently.

Seamless EHR integration and comprehensive suite of connectivity solutions help you take the right actions for your patients.

References: 1. SAMHSA. 2014 National Survey on Drug Use and Health (NSDUH).2. Centers for Disease Control and Prevention. Prescription Painkiller Overdoses in the US. Available at http://www.cdc.gov/vitalsigns/painkilleroverdoses/. Accessed June 6, 2016.3. Finer LB and Zolna MR. Declines in unintended pregnancy in the United States, 2008–2011. N Engl J Med, 2016;374(9):843–852.4. ACOG. Committee Opinion No. 633: Alcohol Abuse and Other Substance Use Disorders: Ethical Issues in Obstetric and 1 Gynecologic Practice. Obstet Gynecol. 2015;125:1529–73.5. National Institute on Drug Abuse. Substance abuse in Women. Available at https://www.drugabuse.gov/sites/default/files/substanceusewomen_drugfacts_final_09032015.pdf.

Accessed June 6, 2016.6. Centers for Disease Control and Prevention. Prescription Painkiller Overdoses A Growing Epidemic, Especially Among Women.

Available at http://cdc.gov/vitalsigns/prescriptionpainkilleroverdoses/. Accessed July 8, 2016.7. Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. MMWR Recomm Rep. 2016;65:1–49. 8. Rudd R, Aleshire N, Zibbell J, et al. Increases in Drug and Opioid Overdose Deaths-United States, 2000-2014. MMWR.2016;1378-82.

QuestDiagnostics.comQuest, Quest Diagnostics, any associated logos, and all associated Quest Diagnostics registered or unregistered trademarks are the property of Quest Diagnostics. All third-party marks—® and ™—are the property of their respective owners. © 2016 Quest Diagnostics Incorporated. All rights reserved. SB5718 7/2016

Contact your Quest Diagnostics sales representative: call 1.866.MYQUEST (1.866.697.8378) or visit QuestDiagnostics.com.

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