Opioid prescriptions decline after scrutiny

N.M. ordered doctors to check data

SANTA FE, N.M. - The number of people receiving opioid pain medication prescriptions or risky overlapping prescriptions has shown a notable decline in New Mexico since the state ordered doctors to check a database that can indicate whether a patient may be receiving narcotics from multiple sources, according to newly released statistics.

New Mexico has strengthened its prescription monitoring program in response to a surge in its drug overdose death rate in 2014, when the state ranked second only to West Virginia.

On Jan. 1, a law went into effect that requires health care providers to screen new and extended opioid prescriptions against a statewide electronic database.

New Mexico State Epidemiologist Michael Landen said this week the database is being used more frequently and responsibly, with a notable decline in prescription practices for addictive opioid pain medications like hydrocodone or fentanyl that have been linked to a the national overdose epidemic.

“We think we’ve seen some improvements in prescribing due to the law,” he said. “There is less high-risk opioid prescription.”

The number of people receiving opioid prescriptions fell by 5 percent for the first three months of the year versus the same 2016 period, decreasing from about 201,000 to 191,000. Those figures do not include prescriptions for opioid anti-craving medications such as buprenorphine used to wean addicts off opioid pills or heroin.

The state also witnessed a 13 percent decline in overlapping opioid prescriptions that can supply one patient with more medication than intended during the same period, and an 11 percent decline in highdose opioid prescriptions that are seen as a factor in the U.S. overdose epidemic.

At the same time, there was little change in socalled chronic opioid prescribing — for people who received opioids for at least 90 days in the past six months. About 55,400 New Mexico residents still fall into that category.

It was too soon to know whether the new monitoring is having an impact on drug overdose deaths, with statistics for 2016 due for release in coming weeks and tallies for early 2017 more than a year away.

New Mexico has been on the front lines of the nation’s intertwined prescription opioid and heroin epidemic for more than a decade. The state has implemented pioneering policies designed to rein in overdose deaths.

The state was the first in 2001 to increase access to the overdose-reversal drug naloxone, and a few years later, it led the way in releasing people from legal liability when they assist in overdose situations.This year, New Mexico became the first U.S. state to require all local and state law enforcement agencies to provide officers with antidote kits in an effort to curb deaths from opioid overdoses.

Overdoses deaths have remained stubbornly high.

In 2015, the drug overdose death rate in New Mexico was 24.8 people per 100,000, well over the national average of 16.3. Seven states had higher overdose death rates that year: West Virginia, New Hampshire, Ohio, Rhode Island, Pennsylvania and Massachusetts.

Another perilous prescription pattern appears to be tapering off in New Mexico — concurrent prescriptions for opioids and benzodiazepine tranquilizers such as Valium or Xanax that together carry higher overdose risks, Landen said.

Emily Kaltenbach, state director for the Drug Policy Alliance, described New Mexico’s prescription monitoring program an important tool that does not share prescription information with law enforcement or dictate prescription practices — actions that could drive patients toward black market opiates.

“I think we’re at a critical point where we need to ask why are our numbers for overdose deaths are not dropping faster,” she said.