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1

CDC grand rounds: prescription drug overdoses - a U.S. epidemic.  

PubMed

In 2007, approximately 27,000 unintentional drug overdose deaths occurred in the United States, one death every 19 minutes. Prescription drug abuse is the fastest growing drug problem in the United States. The increase in unintentional drug overdose death rates in recent years has been driven by increased use of a class of prescription drugs called opioid analgesics. Since 2003, more overdose deaths have involved opioid analgesics than heroin and cocaine combined. In addition, for every unintentional overdose death related to an opioid analgesic, nine persons are admitted for substance abuse treatment, 35 visit emergency departments, 161 report drug abuse or dependence, and 461 report nonmedical uses of opioid analgesics. Implementing strategies that target those persons at greatest risk will require strong coordination and collaboration at the federal, state, local, and tribal levels, as well as engagement of parents, youth influencers, health-care professionals, and policy-makers. PMID:22237030

2012-01-13

2

Prescription Drugs  

MedlinePLUS

... drugs—addiction is a real possibility. How Many Teens Abuse Prescription Drugs? Every day in the United States, an average ... fairly or very easy to get. Why Do Teens Abuse Prescription Drugs? Teens abuse prescription drugs for a number of ...

3

Prescription Drugs  

MedlinePLUS

... Marijuana) LSD (Acid) Marijuana MDMA (Ecstasy/Molly) Methamphetamine PCP/Phencyclidine Prescription Drugs Salvia Steroids (Anabolic) Tobacco Addiction ... Marijuana) LSD (Acid) Marijuana MDMA (Ecstasy/Molly) Methamphetamine PCP/Phencyclidine Prescription Drugs Fentanyl Salvia Steroids (Anabolic) Tobacco ...

4

Overdose  

MedlinePLUS

... Estrogen overdose Ethanol overdose Eucalyptus oil overdose Eugenol oil overdose Fenoprofen calcium overdose Fluoride overdose Heroin overdose Hydrocodone and acetaminophen overdose Hydrogen peroxide overdose ...

5

Serotonin syndrome following overdose of a non-prescription slimming product containing sibutramine: A case report  

Microsoft Academic Search

Introduction: Non-prescription slimming products are popular and can be easily purchased from the Internet. However, adulteration of these products with undeclared substances including prescription drugs is not uncommon. We report a case of serotonin syndrome after an overdose of a non-prescription product containing sibutramine. Case report: A 21-year-old woman presented with somnolence, sinus tachycardia, generalised increase in tone, hyper-reflexia and

PK Lam; KS Leung; TW Wong; HHC Lee; MHY Tang; TWL Mak

2012-01-01

6

Drug overdose emergency room admissions.  

PubMed

The incidence and patterns of drug overdose admissions to the University of Michigan Medical Center Emergency Suite were studied for the first 3 months of each year from 1956 to 1970. Among variables investigated with regard to age, sex, and time comparisons were types of drugs used, purpose of ingestions, medical condition on arrival, disposition after emergency care, and history of treatment for emotional problems. The continuing escalation in drug overdose emergencies, primarily related to intentional self-poisoning, reflects the growing social health problems of drug use proliferation and rise in suicide attempts over the past two decades. Emergency room resources are being increasingly taxed by the psychological and medical care needs of these cases. Renewed effort toward primary prevention is essential. PMID:1032766

Brandwin, M A

1976-01-01

7

Prescription Drug Data Summary.  

National Technical Information Service (NTIS)

Data on prescription drugs are provided in regard to personal health expenditures and outpatient prescription drug insurance coverage, government expenditures for drugs and drug services, drug industry and product information, and drug vendors and prices ...

T. R. Fulda

1974-01-01

8

Individual and Network Factors Associated with Non-fatal Overdose among Rural Appalachian Drug Users  

PubMed Central

Background Fatal overdoses involving prescription opioids have increased significantly in recent years in the United States – especially in rural areas. However, there are scant data about non-fatal overdose among rural drug users. The purpose of this study is to examine the prevalence and correlates of non-fatal overdose and witnessed overdose among rural Appalachian drug users. Methods Rural drug users were participants in a longitudinal study of social networks and HIV transmission. An interviewer-administered questionnaire elicited information in the following domains: sociodemographic characteristics, drug use (including lifetime overdose and witnessed overdose), psychiatric disorders, HIV risk behaviors and social networks (support, drug and sex networks). Negative binomial regression was used to model the number of lifetime overdoses and witnessed overdoses. Results Of the 400 participants, 28% had ever experienced a non-fatal overdose, while 58.2% had ever witnessed an overdose (fatal or non-fatal). Factors independently associated with a greater number of overdoses included having ever been in drug treatment, past 30-day injection of prescription opioids, meeting the criteria for post-traumatic stress disorder and/or antisocial personality disorder and having more members in one's support network. Conclusions Rural drug users with history of overdose were more likely to have injected with prescription opioids – which is different from urban heroin users. However, the remaining correlates of non-fatal overdose among this cohort of rural drug users were similar to those of urban heroin users, which suggests current overdose prevention strategies employed in urban settings may be effective in preventing fatal overdose in this population.

Havens, Jennifer R.; Oser, Carrie B.; Knudsen, Hannah K.; Lofwall, Michelle; Stoops, William W.; Walsh, Sharon L.; Leukefeld, Carl G.; Kral, Alex H.

2010-01-01

9

Prescription Drug Problem  

MedlinePLUS Videos and Cool Tools

... Related MedlinePlus Pages Drugs and Young People Prescription Drug Abuse Teen Health Transcript Some sobering findings today about our ... 42% who have misused or abused a prescription drug say they got it out of ... points? Teen abuse of prescription pain relievers like Vicodin and OxyContin ...

10

Patterns of prescription drug misuse among young injection drug users.  

PubMed

Misuse of prescription drugs and injection drug use has increased among young adults in the USA. Despite these upward trends, few studies have examined prescription drug misuse among young injection drug users (IDUs). A qualitative study was undertaken to describe current patterns of prescription drug misuse among young IDUs. Young IDUs aged 16-25 years who had misused a prescription drug, e.g., opioids, tranquilizers, or stimulants, at least three times in the past 3 months were recruited in 2008 and 2009 in Los Angeles (n = 25) and New York (n = 25). Informed by an ethno-epidemiological approach, descriptive data from a semi-structured interview guide were analyzed both quantitatively and qualitatively. Most IDUs sampled were both homeless and transient. Heroin, prescription opioids, and prescription tranquilizers were frequently misused in the past 30 days. Qualitative results indicated that young IDUs used prescription opioids and tranquilizers: as substitutes for heroin when it was unavailable; to boost a heroin high; to self-medicate for health conditions, including untreated pain and heroin withdrawal; to curb heroin use; and to reduce risks associated with injecting heroin. Polydrug use involving heroin and prescription drugs resulted in an overdose in multiple cases. Findings point to contrasting availability of heroin in North American cities while indicating broad availability of prescription opioids among street-based drug users. The results highlight a variety of unmet service needs among this sample of young IDUs, such as overdose prevention, drug treatment programs, primary care clinics, and mental health services. PMID:22684424

Lankenau, Stephen E; Teti, Michelle; Silva, Karol; Bloom, Jennifer Jackson; Harocopos, Alex; Treese, Meghan

2012-12-01

11

Death by drug overdose: impact on families.  

PubMed

Death by overdose is loaded with social/moral stigmas, in addition to strong feelings of anger, helplessness, guilt and shame in the families. The objective of this study was to analyze the impact of these feelings on families facing death by overdose. Qualitative methodology was used to study six families with a history of death by overdose of one of their members. The interview was open, and guided by the question "What did you feel with the death of your family member by overdose and what was the impact of this death on your family as a whole?" The families were grouped into two categories: families who knew about the drug use of their family member, and families who were not aware of it. The reports show that secrecy regarding drug use followed by death by overdose arouses feelings of anger, guilt, helplessness, and deprives the family members of information that could allow them to take action. As regards families that were aware of the drug use, there seems to be a "veiled preparation" for a possible death by overdose, bringing about ambivalent situations of grief and relief. The report stresses how disturbing it is to lose a family member by overdose, and points to the need for psychological support for those families. PMID:18159785

da Silva, Eroy Aparecida; Noto, Ana Regina; Formigoni, Maria Lucia O S

2007-09-01

12

Prescription Drugs Online  

NSDL National Science Digital Library

The cost of prescription drugs and related concerns have become issues in politics, and there is a growing interest in learning more about exactly how many American use the Internet to find out about prescription drugs, and additionally, how many Americans may be purchasing prescription drugs over the Internet. The Pew Internet & American Life Project has recently released a 17-page report (authored by Susannah Fox) that highlights the results of a 2200-person telephone survey that took place from May to June 2004 on just this subject. Some of the findings include the observation that close to 64 percent of American households contain a regular user of prescription drugs, and that approximately 26 percent of these households have used the Internet to look for information about prescription drugs. Perhaps the most interesting finding from the report is that 62 percent of Americans think purchasing prescription drugs online is less safe than purchasing them at a local pharmacy.

13

Prescription Drugs Online  

NSDL National Science Digital Library

The cost of prescription drugs and related concerns have become issues in politics, and there is a growing interest in learning more about exactly how many American use the Internet to find out about prescription drugs, and additionally, how many Americans may be purchasing prescription drugs over the Internet. The Pew Internet & American Life Project has recently released a 17-page report (authored by Susannah Fox) that highlights the results of a 2200-person telephone survey that took place from May to June 2004 on just this subject. Some of the findings include the observation that close to 64 percent of American households contain a regular user of prescription drugs, and that approximately 26 percent of these households have used the Internet to look for information about prescription drugs. Perhaps the most interesting finding from the report is that 62 percent of Americans think purchasing prescription drugs online is less safe than purchasing them at a local pharmacy.

Fox, Susannah

2007-04-03

14

Prescription drug abuse in Canada and the diversion of prescription drugs into the illicit drug market.  

PubMed

Prescription drug abuse has received considerable attention in media reports in recent years. The purpose of this article is to describe the Canadian situation and context with regards to prescription drug abuse and the diversion of psychotropic prescription drugs into the illicit drug market, with a focus on the need for more data and interventions. Canada ranks within the top 10% of countries in the use of benzodiazepines, opioid prescriptions and stimulants. There are many ways that prescription drugs are diverted into the illicit market and varied reasons for use and abuse. Prescription drug abuse is further related to a number of negative consequences, including overdose. While seniors and women have been the primary focus for research in Canada on prescription drug abuse, adolescents and young adults have received less attention. Systematic epidemiological data specifically on prescription drug abuse in the Canada context are lacking and are needed in order to more clearly understand the reasons for the phenomenon and to develop and implement appropriate interventions. PMID:16350874

Haydon, Emma; Rehm, Jürgen; Fischer, Benedikt; Monga, Neerav; Adlaf, Edward

15

Medicare: Prescription Drug Issues.  

National Technical Information Service (NTIS)

The report contains information about prescription drugs as they relate to the needs of the elderly. It discusses the following questions: (1) To what extent do the elderly need and use prescription drugs and what are the costs to the elderly; (2) What pr...

1987-01-01

16

Prescription Drug Abuse  

MedlinePLUS

... in greater alertness, attention, and energy. Over-the-Counter Drugs Some people mistakenly think that prescription drugs are more powerful because you need a prescription for them. But it's possible to abuse or become addicted to over-the-counter (OTC) ...

17

Prescription Drug Advertising  

Center for Drug Evaluation (CDER)

... Prescription drug advertisements can provide useful information for consumers to work with their health care providers to make wise decisions ... More results from www.fda.gov/drugs/resourcesforyou/consumers

18

California Prescription Drug Pedigree  

Center for Drug Evaluation (CDER)

Text Version... Name and address of each person certifying delivery or receipt of prescription drug ... (effective 1/1/05) ? Surety bond required for all licensed ... More results from www.fda.gov/downloads/drugs/drugsafety

19

Importing Prescription Drugs  

Center for Drug Evaluation (CDER)

... 08/20/2004 Washington DC: Mayor Anthony Williams; ... 04/2004 Massachusetts: Mayor Thomas M. Menino; ... of Prescription Drugs William K. Hubbard ... More results from www.fda.gov/drugs/drugsafety

20

Overdose Prevention and Naloxone Prescription for Opioid Users in San Francisco  

Microsoft Academic Search

Opiate overdose is a significant cause of mortality among injection drug users (IDUs) in the United States (US). Opiate overdose\\u000a can be reversed by administering naloxone, an opiate antagonist. Among IDUs, prevalence of witnessing overdose events is high,\\u000a and the provision of take-home naloxone to IDUs can be an important intervention to reduce the number of overdose fatalities.\\u000a The Drug

Lauren Enteen; Joanna Bauer; Rachel McLean; Eliza Wheeler; Emalie Huriaux; Alex H. Kral; Joshua D. Bamberger

2010-01-01

21

Prescription Drug Abuse  

ERIC Educational Resources Information Center

|This article presents current statistics on nonmedical use of both categories of prescription medications by high school and college students. The incidence of nonmedical use of prescription medications continues to increase among high school and college students. Two categories of drugs that are commonly used for reasons other than those for…

Hamilton, Gloria J.

2009-01-01

22

Overdose experiences among injection drug users in Bangkok, Thailand  

Microsoft Academic Search

BACKGROUND: Although previous studies have identified high levels of drug-related harm in Thailand, little is known about illicit drug overdose experiences among Thai drug users. We sought to investigate non-fatal overdose experiences and responses to overdose among a community-recruited sample of injection drug users (IDU) in Bangkok, Thailand. METHODS: Data for these analyses came from IDU participating in the Mit

M-J Milloy; Nadia Fairbairn; Kanna Hayashi; Paisan Suwannawong; Karyn Kaplan; Evan Wood; Thomas Kerr

2010-01-01

23

Prescription Drug Abuse  

MedlinePLUS

... Prescription drug abuse Guidelines for sites linking to MayoClinic.com Advertisement Mayo Clinic Store Check out these best-sellers and special offers on books and newsletters from Mayo Clinic. Try Mayo Clinic Health Letter ... answers to live stronger, longer and healthier at any age ...

24

Prescription Drug Monitoring Programs and Other Interventions to Combat Prescription Opioid Abuse  

PubMed Central

The Center for Disease Control and Prevention (CDC) has published significant data and trends related to opioid prescription pain relievers (OPR). In 2008, 20,044 deaths were attributed to prescription drug overdose of which 14,800 (73.8%) were due to OPR, an amount greater than the number of overdose deaths from heroin and cocaine combined. The majority of these deaths were unintentional. Between 1999–2008, overdose deaths from OPR increased almost four-fold. Correspondingly, sales of OPR were four times greater in 2010 than in 1999. Most significant to emergency physicians is the estimate that 39% of all opioids prescribed, administered or continued come from the emergency department (ED). We present findings from the CDC’s Morbidity and Mortality Weekly Report (MMWR) with commentary on current recommendations and policies for curtailing the OPR epidemic.1

Chakravarthy, Bharath; Shah, Shyam; Lotfipour, Shahram

2012-01-01

25

Office of Prescription Drug Promotion  

Center for Drug Evaluation (CDER)

... of OTC drugs is regulated by the Federal Trade Commission, but FDA oversees the advertising of prescription drugs. Advertisements for a drug ... More results from www.fda.gov/drugs/guidancecomplianceregulatoryinformation/surveillance

26

Can we prevent drug related deaths by training opioid users to recognise and manage overdoses?  

PubMed Central

Background Naloxone has been evidenced widely as a means of reducing mortality resulting from opiate overdose, yet its distribution to drug users remains limited. However, it is drug users who are most likely to be available to administer naloxone at the scene and who have been shown to be willing and motivated to deliver this intervention. The current study builds on a national training evaluation in England by assessing 6-month outcome data collected primarily in one of the participating centres. Methods Seventy patients with opioid dependence syndrome were trained in the recognition and management of overdoses in Birmingham (n = 66) and London (n = 4), and followed up six months after receiving naloxone. After successful completion of the training, participants received a supply of 400 micrograms of naloxone (in the form of a preloaded syringe) to take home. The study focused on whether participating users still had their naloxone, whether they retained the information, whether they had witnessed an overdose and whether they had naloxone available and were still willing to use it in the event of overdose. Results & Discussion The results were mixed - although the majority of drug users had retained the naloxone prescribed to them, and retention of knowledge was very strong in relation to overdose recognition and intervention, most participants did not carry the naloxone with them consistently and consequently it was generally not available if they witnessed an overdose. The paper discusses the reasons for the reluctance to carry naloxone and potential opportunities for how this might be overcome. Future issues around training and support around peer dissemination are also addressed. Conclusion Our findings confirm that training of drug users constitutes a valuable resource in the management of opiate overdoses and growth of peer interventions that may not otherwise be recognised or addressed. Obstacles have been identified at individual (transportability, stigma) and at a systems level (police involvement, prescription laws). Training individuals does not seem to be sufficient for these programmes to succeed and a coherent implementation model is necessary.

Gaston, Romina Lopez; Best, David; Manning, Victoria; Day, Ed

2009-01-01

27

Adolescent Nonmedical Prescription Drug Use  

ERIC Educational Resources Information Center

|For many adolescents today, the most common form of substance use is nonmedical prescription drug use. Fittingly, many researchers, policy makers, and people who work with youth are concerned about the serious problems associated with nonmedical prescription drug use (NMPDU). In this article, authors Jason Ford and William Watkins provide an…

Ford, Jason A.; Watkins, William C.

2012-01-01

28

Regulation of Prescription Drug Promotion  

Center for Drug Evaluation (CDER)

Text Version... Safer (fewer side effects, lower severity) than ... ensure that prescription drug advertising and promotion ... sensitization; effect not established in ... More results from www.fda.gov/downloads/drugs/developmentapprovalprocess

29

Incidence of Adverse Cardiovascular Events in Adults Following Drug Overdose  

PubMed Central

Objectives Drug overdose is a leading cause of cardiac arrest and is currently the second leading cause of overall injury-related fatality in the United States. Despite these statistics, the incidence of adverse cardiovascular events (ACVEs) in emergency department (ED) patients following acute drug overdose is unknown. With this study, we address the 2010 American Heart Association Emergency Cardiovascular Care update calling for research to characterize the incidence of in-hospital ACVE following drug overdose. Methods This was a prospective cohort study at two tertiary care hospitals over 12 months. Consecutive adult ED patients with acute drug overdose were prospectively followed to hospital discharge. The main outcome was occurrence of in-hospital ACVE, defined as the occurrence of one or more of the following: myocardial injury, shock, ventricular dysrhythmia, and cardiac arrest. Results There were 459 ED patients with suspected drug overdose, of whom 274 acute drug overdose qualified and were included for analysis (mean [±SE] age = 40.3 [±1.0] years; 63% male). Hospital course was complicated by ACVE in 16 patients (some had more than one): 12 myocardial injury, three shock, two dysrhythmia, and three cardiac arrest. The incidence of ACVE was 5.8% overall (95% confidence interval [CI] = 3.6% to 9.3%) and 10.7% (95% CI = 6.6% to 16.9%) among inpatient admissions, with all-cause mortality at 0.7% (95% CI = 0.2% to 2.6%). Conclusions Based on this study of adult patients with acute drug overdose, ACVE may occur in up to 9.3% overall and up to 16.9% of hospital admissions. Implications for the evaluation and triage of ED patients with acute drug overdose require further study with regard to optimizing interventions to prevent adverse events.

Manini, Alex F.; Nelson, Lewis S.; Stimmel, Barry; Vlahov, David; Hoffman, Robert S.

2012-01-01

30

The prescription drug abuse epidemic.  

PubMed

In the United States, the nonmedical use of prescription drugs is the second most common illicit drug use, behind only marijuana. This article discusses the abuse issues with three of the most widely abused prescription drugs: opioids, central nervous system (CNS) depressants (eg, benzodiazepines), and stimulants (eg, amphetamine-dextroamphetamine and methylphenideate) in the United States. Efforts to deal with the problem are described as well. PMID:22939296

Yu, Hoi-Ying Elsie

2012-09-01

31

Prescription and over-the-counter medication in deliberate self-poisoning and accidental overdosing--preliminary study.  

PubMed

186 case records of patients who overdosed pharmaceuticals (confirmed by toxicological lab analysis) hospitalized at the Department of Clinical Toxicology during three months of 2000 were analyzed for age, sex, type of medication, reason for poisoning (intentional or accidental overdosing). Patients poisoned with prescription medication (Rx group) were compared with those who overdosed nonprescription (OTC-group) medications (alone or combined with Rx). Relative frequency of medication drug poisoning was highest in the 40-49 age group (28.5%) and was followed by the group of young adults (20-29 years; 24.2%). The lowest frequency (2.2%) was noted in the 60-69 age group. Of 186 cases analyzed, in 163 (87.6%) prescription medication (Rx) and in 23 (12.4%) OTC alone or co-ingested with Rx were involved (chi2 = 63.9; p < 0.001). The Rx and OTC groups were not significantly different as to reason for poisoning (chi2 = 0.7; p = 0.792) with significant overrepresentation of deliberate ingestion in both the group analysed (chi2 = 114.39; p < 0.001 for Rx, and chi2 = 13.49; p = 0.002 for OTC). Most adults attempting suicide used Rx with the highest incidence in the 40-49 age group (31.1%). Adolescents (14-19 years) with female over-representation ingested rather OTC pharmaceuticals (40.9%). Acetaminophen (alone or combined with benzodiazepines or/and ethanol) and nonsteroidal anti-inflammatory drugs (NSAIDs) were the most common OTC medications used for deliberate self-poisoning. PMID:16225126

Szkolnicka, Beata

2005-01-01

32

Disability, Medicare, and Prescription Drugs.  

National Technical Information Service (NTIS)

This report documents the unique need of disabled Medicare beneficiaries for prescription drugs, provides state-by-state information on these beneficiaries, illustrates how the private insurance market has not been responsive to their needs, and validates...

2000-01-01

33

Evaluation of Deaths from Drug Overdose. A Clinicopathologic Study.  

National Technical Information Service (NTIS)

The toxicologic and pathologic findings in selected cases from a group of 300 deaths from drug overdose are presented. These include 146 deaths from seven of the more common drugs, which accounted for 49% of this group of 300 cases. Two series of combined...

N. S. Irey R. C. Froede

1973-01-01

34

Drug overdose and the full moon.  

PubMed

This study assessed the relationship between the phase of the full moon and the incidence of overdose as reported in five metropolitan Phoenix hospitals and the Maricopa County Medical Examiner over the 15-mo. period from January 1, 1976, through and including March 31, 1977. A chi-squared analysis was performed and no significant difference between the distribution of cases occurring during the full moon phase and that outside of these periods was found. PMID:7367156

Sharfman, M

1980-02-01

35

Neuropsychiatric Effects of Prescription Drug Abuse  

Microsoft Academic Search

Prescription drugs have become a major category of abused substances, and there is evidence that the prevalence of prescription\\u000a drug abuse may soon overtake that of illicit drugs. Study of prescription drugs has been hampered by vague terminology, since\\u000a prescription drugs are only separated from other drugs of abuse by social and legal constructs. Reviewed herein is published\\u000a literature on

Jason P. Caplan; Lucy A. Epstein; Davin K. Quinn; Jonathan R. Stevens; Theodore A. Stern

2007-01-01

36

Marketing Materials for Medicare Prescription Drug Plans.  

National Technical Information Service (NTIS)

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 added voluntary outpatient prescription drug coverage to Medicare. Private health insurance organizations (hereafter referred to as sponsors) contract with CMS to offer PDPs. Spons...

D. R. Levinson

2008-01-01

37

Prescription Drug Abuse and Youth. Information Brief.  

ERIC Educational Resources Information Center

|Prescription drugs, a category of psychotherapeutics that comprises prescription-type pain relievers, tranquilizers, stimulants, and sedatives, are among the substances most commonly abused by young people in the United States. Prescription drugs are readily available and can easily be obtained by teenagers who abuse these drugs to experience a…

Department of Justice, Washington, DC. National Drug Intelligence Center.

38

Prescription drug abuse as a public health problem in Ohio: a case report.  

PubMed

Prescription drug overdose is the leading cause of injury death in Ohio, as well as in 16 other states. Responding to the prescription drug epidemic is particularly challenging given the fragmentation of the health care system and that the consequences of addiction span across systems that have not historically collaborated. This case study reports on how Ohio is responding to the prescription drug epidemic by developing cross-system collaboration from local public health nurses to the Governor's office. In summary, legal and regulatory policies can be implemented relatively quickly whereas changing the substance abuse treatment infrastructure requires significant financial investments. PMID:23078426

Winstanley, Erin L; Gay, Joe; Roberts, Lisa; Moseley, Judi; Hall, Orman; Beeghly, B Christine; Winhusen, Theresa; Somoza, Eugene

2012-08-26

39

Potential Prescription Drug Misuse Among the Elderly.  

National Technical Information Service (NTIS)

The study objective was to determine the potential for drug misuse among the elderly residents of Hudson County, New Jersey. The availability of prescription drugs to elderly individuals was measured, and the drug taking knowledge and practice of these in...

V. Maggio J. Brody

1981-01-01

40

Revisiting "the origins of compulsory drug prescriptions".  

PubMed Central

It has been argued that today's prescription drug market originated in the arbitrary acts of the US Food and Drug Administration (FDA), which in 1938 issued regulations creating a class of drugs that could be sold by prescription only. On the basis of the FDA's administrative records, I argue that the 1938 regulations on prescription drug labeling were initiated by industry and then agreed to by the FDA; that contemporaries understood and accepted the reasons for restricting the use of certain drugs; and that the subsequent evolution of these regulations is best understood as an FDA effort to limit industry abuses of the prescription labeling system. This decade-long war of position ended when drug manufacturers persuaded the US Congress to enshrine their version of prescription labeling in law in a highly politicized struggle over government's role in the economy. Images FIGURE 1

Marks, H M

1995-01-01

41

Exposure to prescription drugs labeled for risk of adverse effects of suicidal behavior or ideation among 100 Air Force personnel who died by suicide, 2006-2009.  

PubMed

Prescription drugs for many indications are labeled with warnings for potential risk of suicidal ideation or behavior. Exposures to prescription drugs labeled for adverse effects of suicidal behavior or ideation among 100 Air Force personnel who died by suicide between 2006 and 2009 are described. Air Force registry data were linked to administrative prescription data. Descriptive statistics illustrate utilization: 89 personnel had a prescription history, 35 filled at least one prescription labeled with a warning, 26 had antidepressants on hand at death, and 2 died by drug overdose. Most airmen were not exposed to any prescriptions labeled for risk of suicidal ideation or behavior prior to death by suicide. PMID:22934922

Lavigne, Jill E; McCarthy, Michael; Chapman, Richard; Petrilla, Allison; Knox, Kerry L

2012-08-31

42

Pharmacokinetic strategies for treatment of drug overdose and addiction  

PubMed Central

The pharmacokinetic treatment strategy targets the drug molecule itself, aiming to reduce drug concentration at the site of action, thereby minimizing any pharmacodynamic effect. This approach might be useful in the treatment of acute drug toxicity/overdose and in the long-term treatment of addiction. Phase IIa controlled clinical trials with anticocaine and antinicotine vaccines have shown good tolerability and some efficacy, but Phase IIb and III trials have been disappointing because of the failure to generate adequate antibody titers in most participants. Monoclonal antibodies against cocaine, methamphetamine and phencyclidine have shown promise in animal studies, as has enhancing cocaine metabolism with genetic variants of human butyrylcholinesterase, with a bacterial esterase, and with catalytic monoclonal antibodies. Pharmacokinetic treatments offer potential advantages in terms of patient adherence, absence of medication interactions and benefit for patients who cannot take standard medications.

Gorelick, David A

2012-01-01

43

76 FR 51245 - Branded Prescription Drug Fee  

Federal Register 2010, 2011, 2012, 2013

...RIN 1545-BK34 Branded Prescription Drug Fee AGENCY: Internal Revenue Service (IRS...regulations that provide guidance on the annual fee imposed on covered entities engaged in the...importing branded prescription drugs. This fee was enacted by section 9008 of the...

2011-08-18

44

Patterns of prescription and drug dispensing  

Microsoft Academic Search

Objective: To analyze the patterns of prescriptions and drug dispensing using World Health Organization core drug use indicators and\\u000a some additional indices.Methods: Data were collected prospectively by scrutinizing the prescriptions written by pediatric resident doctors and by interviewing\\u000a parents of 500 outpatient children.Results: The average number of drugs per encounter was 2.9 and 73.4% drugs were prescribed by generic name.

Sunil Karande; Punam Sankhe; Madhuri Kulkarni

2005-01-01

45

The "black box" of prescription drug diversion.  

PubMed

A variety of surveys and studies are examined in an effort to better understand the scope of prescription drug diversion and to determine whether there are consistent patterns of diversion among various populations of prescription drug abusers. Data are drawn from the RADARS System, the National Survey of Drug Use and Health, the Delaware School Survey, and a series of quantitative and qualitative studies conducted in Miami, Florida. The data suggest that the major sources of diversion include drug dealers, friends and relatives, smugglers, pain patients, and the elderly, but these vary by the population being targeted. In all of the studies examined, the use of the Internet as a source for prescription drugs is insignificant. Little is known about where drug dealers are obtaining their supplies, and as such, prescription drug diversion is a "black box" requiring concentrated, systematic study. PMID:20155603

Inciardi, James A; Surratt, Hilary L; Cicero, Theodore J; Kurtz, Steven P; Martin, Steven S; Parrino, Mark W

2009-10-01

46

21 CFR 202.1 - Prescription-drug advertisements.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 false Prescription-drug advertisements. 202.1 Section 202.1 Food... § 202.1 Prescription-drug advertisements. (e) * * * (6...demonstrated by substantial evidence. An advertisement for a prescription drug may...

2013-04-01

47

Prescription drug abuse in the elderly.  

PubMed

The increased use of prescription drugs has brought pain relief too many and often improved the quality of life of elderly patients. But the increase in use and availability of prescription medications-especially controlled substances-brings with it an increased potential for abuse. Studies have shown that intentional abuse of prescription drugs is increasing among all age groups. As the number of persons 65 years of age and older skyrockets with the aging of the baby boomers, experts predict that prescription drug abuse among the elderly also will rise significantly. Efforts to increase awareness of drug abuse among elderly patients, caregivers, and health care practitioners, as well as research into how best to prevent and treat the elderly drug abuser, will be necessary to thwart what could become a significant public health problem. PMID:19275462

Martin, Caren McHenry

2008-12-01

48

Your Guide to Medicare Prescription Drug Coverage  

MedlinePLUS

... a plan that has a coverage gap. Ms. Smith joined the ABC Prescription Drug Plan. Her coverage ... defined on pages 77–80. Monthly Premium—Ms. Smith pays a monthly premium throughout the year. 1. ...

49

Barbiturate intoxication and overdose  

MedlinePLUS

... overdoses of this type of medication involve a mixtures of drugs, usually alcohol and barbiturates, or barbiturates ... 10 people who have a barbiturate overdose or mixture overdose will die. They usually die from heart ...

50

It's time for Canadian community early warning systems for illicit drug overdoses  

Microsoft Academic Search

Although fatal and non-fatal overdoses represent a significant source of morbidity and mortality, current systems of surveillance and communication in Canada provide inadequate measurement of drug trends and lack a timely response to drug-related hazards. In order for an effective early warning system for illicit drug overdoses to become a reality, a number of elements will be required: real-time epidemiologic

Sarah J Fielden; David C Marsh

2007-01-01

51

Subtypes of nonmedical prescription drug misuse  

PubMed Central

This study used three characteristics (i.e., motive, route of administration, and co-ingestion with alcohol) of nonmedical prescription drug misuse across four separate classes (i.e., pain, sedative/anxiety, sleeping and stimulant medications) to examine subtypes and drug related problems. A Web survey was self-administered by a randomly selected sample of 3,639 undergraduate students attending a large Midwestern 4-year U.S. university. Self-treatment subtypes were characterized by motives consistent with the prescription drug's pharmaceutical main indication, oral only routes of administration, and no co-ingestion with alcohol. Recreational subtypes were characterized by recreational motives, oral or non-oral routes, and co-ingestion. Mixed subtypes consisted of other combinations of motives, routes, and co-ingestion. Among those who reported nonmedical prescription drug misuse, approximately 13% were classified into the recreational subtype, while 39% were in the self-treatment subtype, and 48% were in the mixed subtype. There were significant differences in the subtypes in terms of gender, race and prescription drug class. Approximately 50% of those in subtypes other than self-treatment screened positive for drug abuse. The odds of substance use and abuse were generally lower among self-treatment subtypes than other subtypes. The findings indicate subtypes should be considered when examining nonmedical prescription drug misuse, especially for pain medication.

McCabe, Sean Esteban; Boyd, Carol J.; Teter, Christian J.

2010-01-01

52

21 CFR 202.1 - Prescription-drug advertisements.  

Code of Federal Regulations, 2010 CFR

21 Food and Drugs 4 2009-04-01... 2009-04-01 false Prescription-drug...Section 202.1 Food and Drugs FOOD AND DRUG ADMINISTRATION...PRESCRIPTION DRUG ADVERTISING § 202.1 Prescription-drug...quantitative statement of safety or...

2009-04-01

53

21 CFR 202.1 - Prescription-drug advertisements.  

Code of Federal Regulations, 2010 CFR

21 Food and Drugs 4 2010-04-01... 2010-04-01 false Prescription-drug...Section 202.1 Food and Drugs FOOD AND DRUG ADMINISTRATION...PRESCRIPTION DRUG ADVERTISING § 202.1 Prescription-drug...quantitative statement of safety or...

2010-04-01

54

Prescription Drug Coverage and Elderly Medicare Spending  

Microsoft Academic Search

The introduction of Medicare Part D has generated interest in the cost of providing drug coverage to the elderly. Of paramount importance -- often unaccounted for in budget estimates -- are the salutary effects that increased prescription drug use might have on other Medicare spending. This paper uses longitudinal data from the Medicare Current Beneficiary Survey (MCBS) to estimate how

Baoping Shang; Dana P. Goldman

2007-01-01

55

Consumer Perceived Risk Associated with Prescription Drugs  

Microsoft Academic Search

Consumer perceived risk associated with prescription drugs was evaluated using Jacoby and Kaplan's definition of overall risk as a function of performance, safety, financial, psychological, and social risks. Patients in an outpatient pharmacy (n = 100) were asked to evaluate four classes of drugs: cough\\/cold, antihypertensives, sedatives, and hypnotics. The results indicate that consumers do perceive a different level of

Aditi Kare; Suzan Kucukarslan; Stephen Birdwell

1996-01-01

56

Prescription Drug Services on the Internet  

Microsoft Academic Search

Prescription drugs is a topic on the minds of many people these days. With soaring costs for consumers, the politicians see the discussion as a major campaign issue. People on fixed incomes must often choose between purchasing medications or other essential commodities. The managed care industryapplies additional pressure with the constantly changing mix of drugs that are covered under health

Virginia A. Lingle

2001-01-01

57

Methamphetamine overdose  

MedlinePLUS

... Uppers overdose; Overdose - methamphetamine; Crank overdose; Meth overdose; Crystal meth overdose; Speed overdose; Ice overdose ... streets. It may be called meth, crank, speed, crystal meth, and ice. A much weaker form of ...

58

Recreational Prescription Drug Use among College Students  

ERIC Educational Resources Information Center

|The purpose of this study was to explore recreational prescription drug use among undergraduate students. Although anecdotal accounts on this subject abound, empirical research is extremely limited. Data from a survey of a random sample of 734 students at a large public research university in the Northeast were examined. Results indicate that a…

Kolek, Ethan A.

2006-01-01

59

Recreational Prescription Drug Use among College Students  

ERIC Educational Resources Information Center

|The purpose of this study was to explore recreational prescription drug use among undergraduate students. Although anecdotal accounts on this subject abound, empirical research is extremely limited. Data from a survey of a random sample of 734 students at a large public research university in the Northeast were examined. Results indicate that a…

Kolek, Ethan A.

2009-01-01

60

FDA Drug Safety Communication: Prescription ...  

Center for Drug Evaluation (CDER)

... acetaminophen (eg, Tylenol) are not affected by this ... Report side effects to FDA's MedWatch program using ... patients not to drink alcohol while taking ... More results from www.fda.gov/drugs/drugsafety

61

Saving Money On Prescription Drugs  

Center for Drug Evaluation (CDER)

... Loratadine for allergies is a good example of an over-the-counter (OTC ... the active ingredient in Claritin, Alavert, and some generic allergy medicines ... More results from www.fda.gov/drugs/emergencypreparedness/bioterrorismanddrugpreparedness

62

Saving Money On Prescription Drugs  

Center for Drug Evaluation (CDER)

... Gray, who works as a patient advocate two days a week, says she started with 13 patients in 2003 and ... "It takes about four to eight weeks to hear ... More results from www.fda.gov/drugs/resourcesforyou

63

38 CFR 1.515 - Disclosure of information to participate in state prescription drug monitoring programs.  

Code of Federal Regulations, 2013 CFR

...state prescription drug monitoring programs...disclosed to State Prescription Drug Monitoring Programs...this section. (b) Definitions. For the purposes...substance. State Prescription Drug Monitoring...

2013-07-01

64

Subtypes of nonmedical prescription drug misuse  

Microsoft Academic Search

This study used three characteristics (i.e., motive, route of administration, and co-ingestion with alcohol) of nonmedical prescription drug misuse across four separate classes (i.e., pain, sedative\\/anxiety, sleeping, and stimulant medications) to examine subtypes and drug related problems. A Web survey was self-administered by a randomly selected sample of 3639 undergraduate students attending a large midwestern 4-year U.S. university. Self-treatment subtypes

Sean Esteban McCabe; Carol J. Boyd; Christian J. Teter

2009-01-01

65

Patient Characteristics Associated With Nonprescription Drug Use in Intentional Overdose  

Microsoft Academic Search

Objective: Over-the-counter (OTC) medications remain freely available to suicidal patients, de- spite their potential lethality and common use in suicide. The study's main objective was to iden- tify patient characteristics, particularly psychiatric diagnosis associated with the use of OTC medications in intentional overdose. Methods: We retrospectively reviewed 95 charts from patients who presented to St Paul's Hospi- tal from August

Stephen Shalansky; Marianna Leung; Yitzchak Hollander; Janet Raboud

66

Cost Overdose: Growth in Drug Spending for the Elderly, 1992-2010  

NSDL National Science Digital Library

Posted in July by Families USA (see the December 1, 1995 Scout Report), this report is billed as "the first study to both analyze the increase in prescription drug spending for the elderly from 1992 to 2000 and to project further increases over the next 10 years." The report gives data on average expenditures on prescription drugs for seniors, average number of prescriptions, average out-of-pocket costs, total expenditures on health care and prescription drugs for seniors, and more. Among the significant findings: "Annual spending on prescription drugs per elderly American will grow from $559 in 1992 to an estimated $1,205 in 2000, an increase of 116 percent."

2000-01-01

67

Phencyclidine overdose  

MedlinePLUS

... is an illegal street drug that can cause hallucinations and severe agitation. This article discusses overdose due ... does not talk, move, or react) Coma Convulsions Hallucinations High blood pressure Nystagmus (side-to-side eye ...

68

Diazepam overdose  

MedlinePLUS

Farrell SE, Fatovich TM. Benzodiazepines. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap ...

69

Aminophylline overdose  

MedlinePLUS

Shannon MW. Theophylline and caffeine. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap ...

70

Periactin overdose  

MedlinePLUS

Cyproheptadine hydrochloride overdose ... Cyproheptadine ... The generic drug name for Periactin is cyproheptadine hydrochloride. This medicine may also be sold under the following brand names: Klarivitina Nuran Periatinol This list may not be all-inclusive.

71

Pharmacy Benefit Managers and Medicare Beneficiary Access to Prescription Drugs  

Microsoft Academic Search

Despite the fact that prescription drugs are an increasingly important component of modern health care, especially for the elderly and disabled populations suffering from chronic conditions, 35% of Medicare beneficiaries lack any form of prescription drug insurance. Congress is currently debating six major proposals to extend insurance protection to outpatient prescription drugs under Medicare. Five of these proposals suggest the

Joshua Cohen; Jennifer Chee

2001-01-01

72

Resonant Messages to Prevent Prescription Drug Misuse by Teens  

ERIC Educational Resources Information Center

|Prescription drug misuse is a major health problem, particularly among teens. A key step in curbing misuse is the development of effective prescription drug prevention messages. This paper explores the elements of prescription drug misuse prevention messages that resonate with teens using data from focus groups with seventh and eighth grade…

Twombly, Eric C.; Holtz, Kristen D.; Agnew, Christine B.

2011-01-01

73

Patterns of Prescription Medication Diversion among Drug Dealers  

ERIC Educational Resources Information Center

|This research examined the following questions: (1) how do drug dealers acquire their inventories of prescription medications? and (2) which types of prescription medications do dealers most commonly sell? Data are drawn from a National Institute on Drug Abuse-funded research study that examined prescription drug diversion and abuse in South…

Rigg, Khary K.; Kurtz, Steven P.; Surratt, Hilary L.

2012-01-01

74

Prescription drug inquiries must be medically necessary.  

PubMed

The 10th U.S. Circuit Court of Appeals ruled that an employer cannot require workers to disclose which prescription drugs they are taking unless this information is directly related to job performance. The lawsuit was brought by Jane Roe, an employee of the Cheyenne Mountain Conference Resort in Colorado Springs. The resort announced that it would initiate random testing for drug or alcohol use and established a zero-tolerance policy. The policy included a clause requiring employees to report all drugs present within their body system. Roe argued that this blanket prescription policy violated the Americans with Disabilities Act (ADA) and her rights to privacy under a general statute in Colorado. The resort argued that Roe could not be protected by the ADA because she was not a person with a disability. The 10th Circuit disagreed, stating that adopting the resort's logic would defeat the purpose of the ADA, which explicitly prohibits employers from making disability-related inquiries. Since Roe was an account manager with no safety-sensitive duties, the court ruled that the company had no grounds for demanding disclosure of prescription drug use. The appeals court ordered Cheyenne Resort to pay Roe's attorney's fees. PMID:11364728

1997-10-01

75

Prescription Drug Expenditures and Population Demographics  

PubMed Central

Objective To provide detailed demographic profiles of prescription drug utilization and expenditures in order to isolate the impact of demographic change from other factors that affect drug expenditure trends. Data Sources/Study Setting Demographic information and drug utilization data were extracted for virtually the entire British Columbia (BC) population of 1996 and 2002. All residents had public medical and hospital insurance; however their drug coverage resembled the mix of private and public insurance in the United States. Study Design A series of research variables were constructed to illustrate profiles of drug expenditures and drug utilization across 96 age/sex strata. Data Collection/Extraction Methods Drug use and expenditure information was extracted from the BC PharmaNet, a computer network connecting all pharmacies in the province. Principal Findings Per capita drug expenditures increased at an average annual rate of 10.8 percent between 1996 and 2002. Population aging explained 1.0 points of this annual rate of expenditure growth; the balance was attributable to rising age/sex-specific drug expenditures. Conclusions Relatively little of the observed increase in drug expenditures in BC could be attributed to demographic change. Most of the expenditure increase stemmed from the age/sex-specific quantity and type of drugs purchased. The sustainability of drug spending therefore depends not on outside forces but on decisions made by policy makers, prescribers, and patients.

Morgan, Steven G

2006-01-01

76

Abuse of prescription drugs and the risk of addiction  

Microsoft Academic Search

Abuse of several categories of prescription drugs has increased markedly in the United States in the past decade and is now at alarming levels for certain agents, especially opioid analgesics and stimulants. Prescription drugs of abuse fit into the same pharmacological classes as their non-prescription counterparts. Thus, the potential factors associated with abuse or addiction versus safe therapeutic use of

Wilson M. Compton; Nora D. Volkow

2006-01-01

77

Managing tricyclic antidepressant overdose.  

PubMed

Tricyclic antidepressant overdose is the most common cause of death from prescription drugs. Clinical presentation of overdose from the tricyclic agents includes cardiac arrhythmias, hypotension, seizures, coma and anticholinergic signs such as hyperthermia, flushing and intestinal ileus. The highly toxic/lethal level (greater than 1,000 ng per mL) is manifested on electrocardiograms as prolongation of the QRS interval to 100 milliseconds or more. Treatment includes establishment of an airway, proper oxygenation and ventilation, fluid replacement at maintenance levels, cardiac monitoring, gastric lavage and charcoal administration, alkalinization to a blood pH of 7.5 with intravenous sodium bicarbonate, supportive therapy and continued cardiac monitoring after clinical recovery. PMID:1621627

Haddad, L M

1992-07-01

78

42 CFR 423.159 - Electronic prescription drug program.  

Code of Federal Regulations, 2010 CFR

... Electronic media has the same...transmission using electronic media, of prescription...benefit manager, or health plan, either...the dispenser. Electronic prescription drug...effective. (d) Promotion of electronic...

2009-10-01

79

42 CFR 423.159 - Electronic prescription drug program.  

Code of Federal Regulations, 2010 CFR

... Electronic media has the same...transmission using electronic media, of prescription...benefit manager, or health plan, either...the dispenser. Electronic prescription drug...effective. (d) Promotion of electronic...

2010-10-01

80

Buying Prescription Drugs Online: The Do's and Don'ts  

MedlinePLUS

... be buying prescription drugs online through a national pharmacy chain or a mail-order program offered by ... prescription medications? Although there are many legitimate online pharmacies, others aren't licensed in the United States — ...

81

Prevention of overlapping prescriptions of psychotropic drugs by community pharmacists.  

PubMed

The nonmedical use or abuse of prescription drugs, including psychotropic medicines, is a growing health problem in Japan. Patient access to psychotropic drugs, specifically from the oversupply of medications due to overlapping prescriptions, may increase the risk of drug abuse and dependence. However, very little is known about such overlapping prescriptions. Today, the dispensing of prescriptions is generally moving from inside to outside of hospitals, with psychotropic drugs mainly dispensed at community pharmacies. In this study, we used health insurance claims (i.e., receipts) for dispensing as the main source of information in an investigation of overlapping prescriptions of psychotropic drugs. A total of 119 patients were found to have received overlapping prescriptions, as identified by community pharmacists who were members of the Saitama Pharmaceutical Association, using patient medication records, followed by medication counseling and prescription notes for the patient. According to our findings, the most frequently overlapping medication was etizolam. Etizolam can be prescribed for more than 30 days since it is not regulated under Japanese law as a "psychotropic drug." Generally, when a drug can be prescribed for a greater number of days, it increases the likelihood of an overlapping prescription during the same period. As a result, the long-term prescription of etizolam increases the risk of overlapping prescriptions. We also found that the patients who received overlapping prescriptions of etizolam were mostly elderly and the most common pattern was prescription from both internal medicine and orthopedics physicians. Etizolam has wide range of indications that are covered by health insurance. Our results suggest that patients who received overlapping prescriptions of etizolam may receive prescriptions from different prescribers for different purposes. Therefore, it may be appropriate to regulate etizolam as a "psychotropic drug" under Japanese law, thus setting a limit on the period for which it can be prescribed in order to help prevent long-term and overlapping prescriptions. PMID:23393998

Shimane, Takuya; Matsumoto, Toshihiko; Wada, Kiyoshi

2012-10-01

82

Consumer Perceptions of Prescription Drug Websites: A Pilot Study  

Microsoft Academic Search

Consumer perceptions of the information content contained on prescription drug websites was of interest in this investigation. Twenty branded prescription drugs were selected because they were evaluated as being poor consumer choices for safety reasons or because better alternatives existed. Study participants visited each of 20 websites for the selected drugs, and then they answered a series of questions for

Walter Wymer

2010-01-01

83

Prescription Drug Abuse Information in D.A.R.E.  

ERIC Educational Resources Information Center

|This investigation was designed to examine prescription drug-related content and learning objectives in Drug Abuse Resistance Education (D.A.R.E.) for upper elementary and middle schools. Specific prescription-drug topics and context associated with content and objectives were coded. The coding system for topics included 126 topics organized…

Morris, Melissa C.; Cline, Rebecca J. Welch; Weiler, Robert M.; Broadway, S. Camille

2006-01-01

84

The Costs of A Medicare Prescription Drug Benefit  

Microsoft Academic Search

Medicare does not have an outpatient prescription drug benefit. Recently, there has been renewed interest in adding a prescription drug benefit to the program. In this paper, we present a microsimulation model to predict drug expenditures in 2001 for a representative cohort of Medicare beneficiaries under the status quo and three different plans: (1) a catastrophic plan modeled on the

Dana P. Goldman; Geoffrey F. Joyce; Jesse Dylan Malkin

2002-01-01

85

Recommendations t o Prevent t een misuse of Prescription Drugs  

Microsoft Academic Search

tHe misuse of PRescRiPtion DRugs by teens in the United States is a growing problem. Results of na- tional surveys of youth drug use report such substantial increases in nonmedical use of prescription drugs that the current generation of youth has been referred to as \\

Kristen D. Holtz

86

Prescription drug misuse among club drug-using young adults.  

PubMed

Nonmedical prescription (Rx) drug use has recently increased, particularly among young adults. Using time-space sampling to generate a probability-based sample of club-going young adults (18-29), 400 subjects provided data on Rx drug misuse. Club-going young adults misuse Rx drugs at high rates. An overwhelming majority of the sample indicated lifetime use of pain killers, sedatives, and stimulants. A majority indicated recent pain killer use. Variations by gender and sexuality exist in this population. Young lesbian/bisexual women emerged as the group most likely to abuse Rx drugs. Research into the contexts influencing these patterns is imperative. PMID:17994483

Kelly, Brian C; Parsons, Jeffrey T

2007-01-01

87

Prescription Drug Misuse Among Club Drug-Using Young Adults  

PubMed Central

Nonmedical prescription (Rx) drug use has recently increased, particularly among young adults. Using time-space sampling to generate a probability-based sample of club-going young adults (18–29), 400 subjects provided data on Rx drug misuse. Club-going young adults misuse Rx drugs at high rates. An overwhelming majority of the sample indicated lifetime use of pain killers, sedatives, and stimulants. A majority indicated recent pain killer use. Variations by gender and sexuality exist in this population. Young lesbian/bisexual women emerged as the group most likely to abuse Rx drugs. Research into the contexts influencing these patterns is imperative.

Kelly, Brian C.; Parsons, Jeffrey T.

2009-01-01

88

77 FR 12310 - Drugs for Human Use; Drug Efficacy Study Implementation; Prescription Drugs That Contained...  

Federal Register 2010, 2011, 2012, 2013

...DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-1978-N-0441] (formerly 78N-0324); DESI 10392] Drugs for Human Use; Drug Efficacy Study Implementation; Prescription...

2012-02-29

89

Teens and Prescription Drugs: An Analysis of Recent Trends on the Emerging Drug Threat  

ERIC Educational Resources Information Center

|This report synthesizes a number of national studies that show the intentional abuse of prescription drugs to get high is a growing concern, particularly among teens. The analysis shows that teens are turning away from street drugs and using prescription drugs to get high. New users of prescription drugs have caught up with new users of…

Office of National Drug Control Policy, 2007

2007-01-01

90

A Political History of Medicare and Prescription Drug Coverage  

Microsoft Academic Search

This article examines the history of efforts to add prescription drug coverage to the Medicare program. It identifies several important patterns in policymaking over four decades. First, prescription drug coverage has usually been tied to the fate of broader proposals for Medicare reform. Second, action has been hampered by divided government, federal budget deficits, and ideological conflict between those seeking

THOMAS R. O LIVER; P HILIP R. L EE; H ELENE L. L IPTON

2004-01-01

91

The Citizens Health Prescription: Coping with Rising Drug Costs  

Microsoft Academic Search

Prescription drug prices have climbed to unaffordable levels in recent years, creating a serious public policy problem for lawmakers at both the state and federal levels. The U.S. Medicare program only covers the costs of inpatient prescription drugs, and only seventy-five percent of beneficiaries are receiving coverage through some other means. But because of the tremendous power of the pharmaceutical

Shannon Cadres

2002-01-01

92

Exploring Ex Ante Regulatory Mechanisms for Detecting Prescription Drug Misuse  

Microsoft Academic Search

Prescription drug misuse affects several million people and results in direct medical costs for treatment of patients and indirect costs for society that total billions of dollars per year. Most prescription drug misuse is detected after it has occurred (ex post) by law enforcement agencies working with the medical provider community. The current method for enforcement is a litigation approach

Stephen T. Parente

93

Preventing Prescription Drug Abuse in Adolescence: A Collaborative Approach  

ERIC Educational Resources Information Center

|With the growing awareness of adolescent prescription drug abuse, communities and schools are beginning to explore prevention and intervention strategies which are appropriate for their youth. This article provides a framework for developing a collaborative approach to prescription drug abuse prevention--called the Prevention Awareness Team--that…

Jones, Beth A.; Fullwood, Harry; Hawthorn, Melissa

2012-01-01

94

SOCIAL LEARNING THEORY AND NONMEDICAL PRESCRIPTION DRUG USE AMONG ADOLESCENTS  

Microsoft Academic Search

Adolescent substance use is an important area of research in sociology; however, there is a lack of research on nonmedical prescription drug use. The dearth of research on this topic is problematic given the relatively high prevalence of use among adolescents, the drastic increase in use in recent years, and the potential negative consequences from misusing prescription drugs. Using data

Jason A. Ford

2008-01-01

95

Non-Medical Prescription Drug Use among University Students  

ERIC Educational Resources Information Center

|Background: Non-medical prescription drug use is an increasing problem among university students. Purpose: The present study investigated university students' involvement in non-medical prescription drug (NMPD) use and associations between use and other risky behaviors. Methods: A sample of 363 university students completed a four page survey…

Vidourek, Rebecca A.; King, Keith A.; Knopf, Ellen E.

2010-01-01

96

Approved Prescription Drug Products with Therapeutic Equivalence Evaluations.  

National Technical Information Service (NTIS)

This data file was created to allow computer processing of data from the Approved Prescription Drug Products with Therapeutic Equivalence Evaluations (APDP)*. Each record contains the information required to identify a particular drug product. Other infor...

J. Knoben T. McGinnis

1984-01-01

97

Approved Prescription Drug Products with Therapeutic Equivalence Evaluations.  

National Technical Information Service (NTIS)

This data file was created to allow computer processing of data from the Approved Prescription Drug Products with Therapeutic Equivalence Evaluations (APDP). Each record contains the information required to identify a particular drug product. Other inform...

G. C. Collins D. D. Willis

1981-01-01

98

Approved Prescription Drug Products with Therapeutic Equivalence Evaluations.  

National Technical Information Service (NTIS)

This data file was created to allow computer processing of data from the Approved Prescription Drug Products with Therapeutic Equivalence Evaluations (APDP). Each record contains the information required to identify a particular drug product. Other inform...

J. P. Hannan D. D. Willis

1982-01-01

99

Approved Prescription Drug Products with Therapeutic Equivalence Evaluations.  

National Technical Information Service (NTIS)

This data file was created to allow computer processing of data from the Approved Prescription Drug Products with Therapeutic Equivalence Evaluations (APDP). Each record contains the information required to identify a particular drug product. Other Inform...

J. Hannan D. D. Willis

1983-01-01

100

Prescription drug coverage, utilization, and spending among Medicare beneficiaries  

Microsoft Academic Search

Outpatient prescription drugs are not a covered benefit under Medicare. There have been proposals in the past to expand Medicare benefits to include drug coverage, and current discussions dealing with \\

Margaret Davis; John Poisal; George Chulis; Carlos Zarabozo; Barbara Cooper

1999-01-01

101

Prescription Drug Abuse & Diversion: Role of the Pain Clinic  

PubMed Central

The goal of this research is to better understand the role that South Florida pain management clinics may be playing in the abuse and diversion of prescription drugs. This study explores 1) the characteristics and practices of pain clinics that may be facilitating the drug-seeking endeavors of prescription drug abusers and 2) the drug-seeking behaviors of prescription drug abusers who use pain clinics as a primary source for drugs. Thirty in-depth interviews were conducted with prescription drug abusers in South Florida. Interviews were transcribed verbatim and codes were generated based on thematic analyses of the data. Using grounded theory strategies, the analysis revealed six main themes: “pill mills”, on-site pharmacies, liberal prescribing habits, “sponsoring” drug diversion, pain doctor/pharmacy shopping, and faking symptoms/documentation. These findings should provide insights for law enforcement, regulatory agencies, and industry as they attempt to develop appropriate policy initiatives and recommendations for best practices.

Rigg, Khary K.; March, Samantha J.; Inciardi, James A.

2010-01-01

102

Prescription drugs: issues of cost, coverage, and quality.  

PubMed

This Issue Brief closely examines expenditures on prescription drugs, and discusses their potential to substitute for other types of health care services. In addition, it describes employer coverage of prescription drugs, direct-to-consumer advertising of prescription drugs, and potential legislation affecting the prescription drug market. Prescription drug expenditures grew at double-digit rates during almost every year since 1980, accelerating to 14.1 percent in 1997. In contrast, total national health expenditures, hospital service expenditures, and physician service expenditures growth rates decreased from approximately 13 percent in 1980 to less than 5 percent in 1997. Private insurance payments for prescription drugs increased 17.7 percent in 1997, after growing 22.1 percent in 1995 and 18.3 percent in 1996. This growth in prescription drug payments compares with 4 percent or less overall annual growth in private insurance payments for each of those three years. From 1993 to 1997, the overwhelming majority of the increases in expenditures on prescription drugs were attributable to increased volume, mix, and availability of pharmaceutical products. In 1997, these factors accounted for more than 80 percent of the growth in prescription drug expenditures. A leading explanation for the sharp growth in drug expenditures is that prescription drugs are a substitute for other forms of health care. While it is difficult to determine the extent to which this substitution occurs, various studies have associated cost savings with the use of pharmaceutical products in treating specific diseases. Evidence suggests that more appropriate utilization of prescription drugs has the potential to lower total expenditures and improve the quality of care. Also, some studies indicate the U.S. health care system needs to improve the way patients use and physicians prescribe current medications. Prescription drug plans offered by employers are likely to undergo changes to ensure that only the most efficacious drugs are covered. Anecdotal evidence suggests that copayments for prescriptions are going to increase. Some health plans are including prescription drug costs in their capitated payments to physicians. Furthermore, prescription drug plans are expected to use formularies more aggressively. In 1996, an average 5.47 outpatient prescriptions were written for those ages 55-64, compared with more than eight for those age 65 and older. Inevitably, this translated to significantly more spending for prescription drugs by the elderly. In 1994-1995, the average elderly individual (age 65 or older) spent $558 on prescription drugs, while the average 55-64-year-old spent $355. While prescription drugs are showing sharp price increases, they are also becoming more important in the treatment of many diseases. Consequently, both employers and policymakers must carefully balance the design and cost of a drug benefit so that continual innovation is preserved and the benefit can remain affordable and effective. PMID:10539445

Copeland, C

1999-04-01

103

42 CFR 423.56 - Procedures to determine and document creditable status of prescription drug coverage.  

Code of Federal Regulations, 2010 CFR

...creditable status of prescription drug coverage. (a) Definition. Creditable prescription drug coverage means...coverage for outpatient prescription drugs and that does not meet the definition of an excepted...

2009-10-01

104

42 CFR 423.56 - Procedures to determine and document creditable status of prescription drug coverage.  

Code of Federal Regulations, 2010 CFR

...creditable status of prescription drug coverage. (a) Definition. Creditable prescription drug coverage means...coverage for outpatient prescription drugs and that does not meet the definition of an excepted...

2010-10-01

105

42 CFR 423.884 - Requirements for qualified retiree prescription drug plans.  

Code of Federal Regulations, 2012 CFR

...Requirements for qualified retiree prescription drug plans. 423.884 Section 423.884...CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Payments to Sponsors of Retiree Prescription Drug Plans § 423.884 Requirements for...

2012-10-01

106

42 CFR 423.112 - Establishment of prescription drug plan service areas.  

Code of Federal Regulations, 2012 CFR

... false Establishment of prescription drug plan service areas. 423.112 Section...CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Benefits and Beneficiary Protections...423.112 Establishment of prescription drug plan service areas. (a) Service...

2012-10-01

107

42 CFR 423.464 - Coordination of benefits with other providers of prescription drug coverage.  

Code of Federal Regulations, 2012 CFR

...benefits with other providers of prescription drug coverage. 423.464 Section 423...CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Coordination of Part D Plans With Other Prescription Drug Coverage § 423.464...

2012-10-01

108

76 FR 41434 - Removal of Certain Requirements Related to the Prescription Drug Marketing Act; Opportunity for...  

Federal Register 2010, 2011, 2012, 2013

...Requirements Related to the Prescription Drug Marketing Act; Opportunity for Public Comment...remove a section of the Prescription Drug Marketing Act (PDMA) regulations requiring that...various aspects of human prescription drug marketing and distribution. The primary...

2011-07-14

109

Direct-to-consumer advertising of prescription drugs.  

PubMed

In 2007, the pharmaceutical industry spent more than $4.9 billion on direct-to-consumer advertising (DTCA) of prescription drugs in the U.S. Controversy over DTCA has grown since the Food and Drug Administration liberalized its regulations in 1997. Proponents claim that such advertising educates consumers, promotes patient participation in clinical decisions, and improves patient adherence to medication instructions. Opponents argue that such advertising is meant to persuade, not educate, and that it promotes inappropriate use of prescription drugs, or diverts consumers from better alternatives. This Issue Brief summarizes the evidence about the effects of DTCA, and proposes guidelines for improving the utility of prescription drug advertising. PMID:20469541

Frosch, Dominick L; Grande, David

110

Patterns of Psychoactive Drug Prescriptions by House Officers for Nonpatients.  

ERIC Educational Resources Information Center

|The hypothesis that a source of psychoactive drugs for physician trainees is prescription writing by house officers was tested. A survey determined that, of the number of prescriptions written for nonpatients, the largest number was written for family members and friends, and the second largest for fellow house officers. (Author/MLW)|

Clark, Allan W.; And Others

1988-01-01

111

Patterns of prescription medication diversion among drug dealers  

PubMed Central

This research examined the following questions: (1) how do drug dealers acquire their inventories of prescription medications? and (2) which types of prescription medications do dealers most commonly sell? Data are drawn from a National Institute on Drug Abuse-funded research study that examined prescription drug diversion and abuse in South Florida. In-depth semi-structured interviews (n = 50) were conducted with an ethnically diverse sample of prescription drug dealers from a variety of milieus to assess patterns of diversion. Audiotapes of the interviews were transcribed, coded, and thematically analysed using the NVivo 8 software program. Dealers relied on a wide array of diversion methods including visiting multiple pain clinics, working with pharmacy employees to steal medications from pharmacies, and purchasing medications from indigent patients. The type of medication most commonly sold by dealers was prescription opioid analgesics, and to a lesser extent benzodiazepines such as alprazolam. These findings inform public health policy makers, criminal justice officials, the pharmaceutical industry and government regulatory agencies in their efforts to reduce the availability of diverted prescription drugs in the illicit market. Specifically, these data support the need for statewide prescription drug monitoring programs and increased training for healthcare workers who have access to controlled medications.

Rigg, Khary K.; Kurtz, Steven P.; Surratt, Hilary L.

2012-01-01

112

Medicare program; Medicare Advantage and prescription drug benefit programs: negotiated pricing and remaining revisions; prescription drug benefit program: payments to sponsors of retiree prescription drug plans. Final rule.  

PubMed

This final rule implements and finalizes provisions regarding the reporting of gross covered retiree plan-related prescription drug costs (gross retiree costs) and retained rebates by Retiree Drug Subsidy (RDS) sponsors; and the scope of our waiver authority under the Social Security Act (the Act). PMID:22359793

2012-01-12

113

Non-medical use of prescription drugs: implications for NPs.  

PubMed

Nurse practitioners are the first line of defense when combating the problem of nonmedical use of prescription drugs. This article outlines related clinical issues and provides tools and treatment options to use with patients and the community. PMID:22739464

Bettinardi-Angres, Kathy; Bickelhaupt, Ethan; Bologeorges, Stephanie

2012-07-10

114

Consumer responses to direct to consumer prescription drug advertising  

Microsoft Academic Search

Purpose – The purpose of this paper is to identify the types of patients most likely to visit physicians in response to direct to consumer prescription drug advertising (DTCA). Design\\/methodology\\/approach – The study used data from a national telephone survey, “Public Health Impact of Direct-to-Consumer Advertising of Prescription Drugs, July 2001-January 2002: [United States].” It included data on respondents' health

Hai D. B. Chen; Norman V. Carroll

2007-01-01

115

Absolute contraindications in relation to potential drug interactions in outpatient prescriptions: analysis of the first five million prescriptions in 1999  

Microsoft Academic Search

Objectives Adverse drug interactions increase morbidity and mortality. To prevent these, situations leading to adverse prescriptions must be clarified. This study quantifies and analyses prescriptions with potential adverse drug interactions in primary health care in the North of France over a 3-month period. Methods All prescriptions administered between 1 January 1999 and 31 March 1999 were analysed to identify potential

Laurence Guédon-Moreau; Dominique Ducrocq; Marie-Francoise Duc; Yves Quieureux; Catherine L’Hôte; Jean Deligne; Jacques Caron

2004-01-01

116

Absolute contraindications in relation to potential drug interactions in outpatient prescriptions: analysis of the first five million prescriptions in 1999  

Microsoft Academic Search

Objectives Adverse drug interactions increase morbidity and mortality. To prevent these, situations leading to adverse prescriptions must be clarified. This study quantifies and analyses prescriptions with potential adverse drug interactions in primary health care in the north of France over a 3-month period. Methods All prescriptions administered between 1 January and 31 March 1999 were analysed to identify potential interactions

Laurence Guédon-Moreau; Dominique Ducrocq; Marie-Francoise Duc; Yves Quieureux; Catherine L’Hôte; Jean Deligne; Jacques Caron

2003-01-01

117

Drug-related mortality and fatal overdose risk: Pilot cohort study of heroin users recruited from specialist drug treatment sites in London  

Microsoft Academic Search

Fatal overdose and drug-related mortality are key harms associated with heroin use, especially injecting drug use (IDU), and\\u000a are a significant contribution to premature mortality among young adults. Routine mortality statistics tend to underreport\\u000a the number of overdose deaths and do not reflect the wider causes of death associated with heroin use. Cohort studies could\\u000a provide evidence for interpreting trends

Matthew Hickman; Zenobia Carnwath; Peter Madden; Michael Farrell; Cleone Rooney; Richard Ashcroft; Ali Judd; Gerry Stimson

2003-01-01

118

Effect of Prescription Drug Coverage on Health of the Elderly  

PubMed Central

Objective To estimate the effect of prescription drug insurance on health, as measured by self-reported poor health status, functional disability, and hospitalization among the elderly. Data Analyses are based on a nationally representative sample of noninstitutionalized elderly (?65 years of age) from the Medicare Current Beneficiary Survey (MCBS) for years 1992–2000. Study Design Estimates are obtained using multivariable regression models that control for observed characteristics and unmeasured person-specific effects (i.e., fixed effects). Principal Findings In general, prescription drug insurance was not associated with significant changes in self-reported health, functional disability, and hospitalization. The lone exception was for prescription drug coverage obtained through a Medicare HMO. In this case, prescription drug insurance decreased functional disability slightly. Among those elderly with chronic illness and older (71 years or more) elderly, prescription drug insurance was associated with slightly improved functional disability. Conclusions Findings suggest that prescription drug coverage had little effect on health or hospitalization for the general population of elderly, but may have some health benefits for chronically ill or older elderly.

Khan, Nasreen; Kaestner, Robert; Lin, Swu-Jane

2008-01-01

119

Benefit and Risk Information in Prescription Drug Advertising  

Microsoft Academic Search

As pharmaceutical companies began to advertise prescription drugs directly to consumers as well as to physicians, understanding the impact of benefit and risk information in drug advertising on physicians and consumers has become more critical. This paper reviews previous empirical studies that examined the content of benefit and risk information in drug advertising and its potential effects on physicians' subsequent

Steven W. Kopp; Hae-Kyong Bang

2000-01-01

120

[Drug prescription for pregnant women: a pharmacoepidemiological study].  

PubMed

Prescription drug use by pregnant women should be viewed as a public health issue, since there are numerous gaps in knowledge on the consequences for both the mother and the fetus. Pharmacoepidemiological studies can help minimize the inherent risks in drug treatment by establishing a profile of drug consumption during pregnancy, providing an evaluation of this service, and identifying intervention measures. The purpose of this study was to establish a prescription profile for pregnant women treated under the National Health System (SUS) in Piracicaba, São Paulo State, Brazil, using prescription indicators recommended by the World Health Organization and the U.S. Food and Drug Administration classification of medicines according to risk to the fetus. According to the current study, during prenatal consultations 44.7% of the women received drug prescriptions, and the most widely prescribed group of drugs were those acting on the hematopoietic system (34.9%). Of this total, 26.0% of the drugs were included in fetal risk category C, 1.5% in category D, and 1.5% in category E. These data point to the medicalization of pregnancy and the need for intervention measures aimed at rational prescription drug use during the prenatal period. PMID:15300293

Carmo, Thais Adriana do; Nitrini, Sandra Maria O O

2004-07-29

121

Senior Citizens and the Burden of Prescription Drug Outlays: What Lessons for the Medicare Prescription Drug Benefit?  

Microsoft Academic Search

This article uses data from a cohort of elderly and retired persons over the 1996-2001 period in the US to (i) determine the extent to which changes in socioeconomic or demographic characteristics, particularly age, income and education, impact the total amount that is spent on prescription drugs and (ii) to analyse the predictors of individual out-of-pocket (OOP) prescription drug outlays

Panos Kanavos; Marin Gemmill

2004-01-01

122

Prescription drug capitation: risk versus reward.  

PubMed

The unpredictable past and future of the prescription benefit business has resulted in an acute interest by plan sponsors in the concept of capitation. Capitation is effectively an insurance policy, offered by the provider, which will guarantee the cost of the prescription benefit. Such guarantees relative to the cost of the plan are attractive to the sponsor because they minimize risk and facilitate rate setting for HMOs and PPOs--and facilitate budgeting for corporate sponsors. Is capitation a cost-effective win-win alternative to traditional average wholesale price-based arrangements? PMID:10135997

Watt, G T

1994-07-01

123

Iron overdose  

MedlinePLUS

Ferrous sulfate overdose; Ferrous gluconate overdose; Ferrous fumarate overdose ... Iron is an ingredient in many mineral and vitamin supplements. Iron ... (Femiron, Feostat) Note: This list may not be all-inclusive.

124

Tricyclic antidepressant overdose: a review  

PubMed Central

Overdoses of tricyclic antidepressants are among the commonest causes of drug poisoning seen in accident and emergency departments. This review discusses the pharmacokinetics, clinical presentation and treatment of tricyclic overdose.

Kerr, G; McGuffie, A; Wilkie, S

2001-01-01

125

42 CFR 423.104 - Requirements related to qualified prescription drug coverage.  

Code of Federal Regulations, 2010 CFR

...includes- (i) Basic prescription drug coverage, as defined...excluded as Part D drugs under paragraph (2)(ii) of the definition of Part D drug under § 423.100...of defined standard prescription drug coverage, as...

2009-10-01

126

42 CFR 423.104 - Requirements related to qualified prescription drug coverage.  

Code of Federal Regulations, 2010 CFR

...includes- (i) Basic prescription drug coverage, as defined...excluded as Part D drugs under paragraph (2)(ii) of the definition of Part D drug under § 423.100...of defined standard prescription drug coverage, as...

2010-10-01

127

21 CFR 203.50 - Requirements for wholesale distribution of prescription drugs.  

Code of Federal Regulations, 2010 CFR

...wholesale distribution of prescription drugs. 203.50 Section 203.50 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...GENERAL PRESCRIPTION DRUG MARKETING Wholesale...

2009-04-01

128

21 CFR 203.50 - Requirements for wholesale distribution of prescription drugs.  

Code of Federal Regulations, 2010 CFR

...wholesale distribution of prescription drugs. 203.50 Section 203.50 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...GENERAL PRESCRIPTION DRUG MARKETING Wholesale...

2010-04-01

129

75 FR 12756 - Agency Information Collection Activities: Proposed Collection; Comment Request; Prescription Drug...  

Federal Register 2010, 2011, 2012, 2013

...DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration...Prescription Drug Advertisements AGENCY: Food...and other forms of information technology...Prescription Drug Advertisements--21 CFR 202...Section 502(n) of the Federal Food, Drug,...

2010-03-17

130

Concentrations of scheduled prescription drugs in blood of impaired drivers: considerations for interpreting the results.  

PubMed

We report the concentrations of scheduled prescription drugs in blood samples from people arrested in Sweden for driving under the influence of drugs (DUID). The investigation covered a 2 year period 2004 (N = 7052 cases) and 2005 (N = 7759 cases) and was prompted by recent legislation stipulating zero-concentration limits in blood for controlled substances. However, prescription drugs are exempt from the zero-limit law provided that the medication was being used in accordance with a doctor's prescription. The blood concentrations of various psychoactive substances were compared with the limits of quantitation of the analytic method used and the so-called therapeutic concentration range according to various reference books and tabulations. Diazepam [N = 1950 (26%)] and nordazepam [N = 2168 (28%)] were the therapeutic agents most frequently identified in these forensic blood samples along with other benzodiazepines such as alprazolam [N = 430 (5.6%)], flunitrazepam [N = 308 (4.0%)], and nitrazepam [N = 222 (2.9%)]. The newer hypnotics, exemplified by zolpidem [N = 148 (1.9%)] and zopiclone [N = 111 (1.5%)], were also high on the list of psychoactive substances identified. Interpreting the concentration of a prescription drug in blood in relation to whether the person had taken an overdose or was abusing the substance in question is not always easy. The age, gender, degree of obesity, and ethnicity of the person concerned; the pharmacokinetic profile of the drug; polymorphism of drug-metabolizing enzymes as well as liver and kidney function and blood hematocrit need to be considered. Among preanalytic factors, stability of the drug in blood after sampling, the type of tubes and preservatives used, the dosage form and route of administration deserve consideration. When therapeutic drug monitoring concentrations are compared with forensic toxicology results, then the plasma-to-whole blood distribution ratio of the drug also needs to be considered. In blood samples from DUID suspects, the concentrations of many commonly used sedatives and hypnotics exceeded the accepted therapeutic limits, which gives an indication of the abuse potential of these types of medications. PMID:17417081

Jones, A W; Holmgren, A; Kugelberg, F C

2007-04-01

131

Prevalence of the Prescription of Potentially Interacting Drugs  

PubMed Central

The use of multiple medications is becoming more common, with a correspondingly increased risk of untoward effects and drug-related morbidity and mortality. We aimed at estimating the prevalence of prescription of relevant potentially interacting drugs and at evaluating possible predictors of potentially interacting drug exposure. We retrospectively analyzed data on prescriptions dispensed from January 2004 to August 2005 to individuals of two Italian regions with a population of almost 2.1 million individuals. We identified 27 pairs of potentially interacting drugs by examining clinical relevance, documentation, and volume of use in Italy. Subjects who received at least one prescription of both drugs were selected. Co-prescribing denotes “two prescriptions in the same day”, and concomitant medication “the prescription of two drugs with overlapping coverage”. A logistic regression analysis was conducted to examine the predictors of potential Drug-Drug Interaction (pDDIs). 957,553 subjects (45.3% of study population) were exposed to at least one of the drugs/classes of the 27 pairs. Overall, pDDIs occurred 2,465,819 times. The highest rates of concomitant prescription and of co-prescription were for ACE inhibitors+NSAIDs (6,253 and 4,621/100,000 plan participants). Considering concomitance, the male/female ratio was <1 in 17/27 pairs (from 0.31 for NSAIDs-ASA+SSRI to 0.74 for omeprazole+clopidogrel). The mean age was lowest for methotrexate pairs (+omeprazole, 59.9 years; +NSAIDs-ASA, 59.1 years) and highest for digoxin+verapamil (75.4 years). In 13/27 pairs, the mean ages were ?70 years. On average, subjects involved in pDDIs received ?10 drugs. The odds of exposure were more frequently higher for age ?65 years, males, and those taking a large number of drugs. A substantial number of clinically important pDDIs were observed, particularly among warfarin users. Awareness of the most prevalent pDDIs could help practitioners in preventing concomitant use, resulting in a better quality of drug prescription and potentially avoiding unwanted side effects.

Tragni, Elena; Casula, Manuela; Pieri, Vasco; Favato, Giampiero; Marcobelli, Alberico; Trotta, Maria Giovanna; Catapano, Alberico Luigi

2013-01-01

132

Prevalence of the prescription of potentially interacting drugs.  

PubMed

The use of multiple medications is becoming more common, with a correspondingly increased risk of untoward effects and drug-related morbidity and mortality. We aimed at estimating the prevalence of prescription of relevant potentially interacting drugs and at evaluating possible predictors of potentially interacting drug exposure. We retrospectively analyzed data on prescriptions dispensed from January 2004 to August 2005 to individuals of two Italian regions with a population of almost 2.1 million individuals. We identified 27 pairs of potentially interacting drugs by examining clinical relevance, documentation, and volume of use in Italy. Subjects who received at least one prescription of both drugs were selected. Co-prescribing denotes "two prescriptions in the same day", and concomitant medication "the prescription of two drugs with overlapping coverage". A logistic regression analysis was conducted to examine the predictors of potential Drug-Drug Interaction (pDDIs). 957,553 subjects (45.3% of study population) were exposed to at least one of the drugs/classes of the 27 pairs. Overall, pDDIs occurred 2,465,819 times. The highest rates of concomitant prescription and of co-prescription were for ACE inhibitors+NSAIDs (6,253 and 4,621/100,000 plan participants). Considering concomitance, the male/female ratio was <1 in 17/27 pairs (from 0.31 for NSAIDs-ASA+SSRI to 0.74 for omeprazole+clopidogrel). The mean age was lowest for methotrexate pairs (+omeprazole, 59.9 years; +NSAIDs-ASA, 59.1 years) and highest for digoxin+verapamil (75.4 years). In 13/27 pairs, the mean ages were ?70 years. On average, subjects involved in pDDIs received ?10 drugs. The odds of exposure were more frequently higher for age ?65 years, males, and those taking a large number of drugs. A substantial number of clinically important pDDIs were observed, particularly among warfarin users. Awareness of the most prevalent pDDIs could help practitioners in preventing concomitant use, resulting in a better quality of drug prescription and potentially avoiding unwanted side effects. PMID:24147143

Tragni, Elena; Casula, Manuela; Pieri, Vasco; Favato, Giampiero; Marcobelli, Alberico; Trotta, Maria Giovanna; Catapano, Alberico Luigi

2013-10-11

133

Whole bowel irrigation as a decontamination procedure after acute drug overdose.  

PubMed

Whole bowel irrigation, routinely used before colonoscopy, is evaluated as a potential gastrointestinal decontamination procedure for acute drug overdose. Nine adult volunteers, who served as their own controls, each ingested 5.0 g of ampicillin trihydrate on two occasions, one week apart. Whole bowel irrigation with polyethylene glycol electrolyte lavage solution was performed one hour after one ingestion. Serial serum ampicillin levels, electrolytes, osmolalities, body weights, and hematocrits were obtained. The areas under the concentration vs time curves for ampicillin were computed for both groups, and their means were compared. Mean duration of the procedure was 234 minutes and mean volume of infused polyethylene glycol electrolyte lavage solution was 7.7 L. Whole bowel irrigation produced a 67% decrease in ampicillin absorption and there were no significant changes in body weight, hematocrit, serum electrolytes, or osmolality. We conclude that whole bowel irrigation is an effective and safe gastrointestinal decontamination procedure for acute drug ingestion. PMID:3579442

Tenenbein, M; Cohen, S; Sitar, D S

1987-05-01

134

Should the US allow prescription drug reimports from Canada?  

Microsoft Academic Search

As a result of public outrage over lower prescription drug prices in Canada, Congress passed legislation that would allow these drugs to be imported into the US. The lower Canadian prices reflect price regulation. Opponents of allowing these imports have argued that the US will import Canadian price controls and that profits of pharmaceutical companies will be hurt. In this

Paul Pecorino

2002-01-01

135

How Predictors of Prescription Drug Abuse Vary by Age  

Microsoft Academic Search

Previous studies that have identified the predictors of prescription drug abuse have either focused on a specific age group or pooled all age groups together into one sample. This approach constrains the predictors to have the same effect across age groups. In this study, we use the 2001 to 2003 National Survey on Drug Use and Health to estimate separate

Jeremy Arkes; Martin Y. Iguchi

2008-01-01

136

Prescription Drug Advertising: Questions and Answers  

Center for Drug Evaluation (CDER)

... It includes technical information about the chemistry of the drug, its ... It is written for healthcare providers. ... description of the drug, how it works in the ... More results from www.fda.gov/drugs/resourcesforyou/consumers

137

Incidence and risk factors for non-fatal overdose among a cohort of recently incarcerated illicit drug users  

PubMed Central

Background Release from prison is associated with a markedly increased risk of both fatal and non-fatal drug overdose, yet the risk factors for overdose in recently released prisoners are poorly understood. The aim of this study was to identify risk and protective factors for non-fatal overdose (NFOD) among a cohort of illicit drug users in Vancouver, Canada, according to recent incarceration. Methods Prospective cohort of 2515 community-recruited illicit drug users in Vancouver, Canada, followed from 1996 to 2010. We examined factors associated with NFOD in the past six months separately among those who did and did not also report incarceration in the last six months. Results One third of participants (n=829, 33.0%) reported at least one recent NFOD. Among those recently incarcerated, risk factors independently and positively associated with NFOD included daily use of heroin, benzodiazepines, cocaine or methamphetamine, binge drug use, public injecting and previous NFOD. Older age, methadone maintenance treatment and HIV seropositivity were protective against NFOD. A similar set of risk factors was identified among those who had not been incarcerated recently. Conclusions Among this cohort, and irrespective of recent incarceration, NFOD was associated with a range of modifiable risk factors including more frequent and riskier patterns of drug use. Not all ex-prisoners are at equal risk of overdose and there remains an urgent need to develop and implement evidence-based preventive interventions, targeting those with modifiable risk factors in this high risk group.

Kinner, Stuart A.; Milloy, M-J.; Wood, Evan; Qi, Jiezhi; Zhang, Ruth; Kerr, Thomas

2013-01-01

138

Medical Use, Illicit Use, and Diversion of Abusable Prescription Drugs  

PubMed Central

The authors investigated the medical use, illicit use, and diversion of 4 distinct classes of abusable prescription medication (sleeping medication, sedative or anxiety medication, stimulant medication, and pain medication) in a random sample of undergraduate students. In spring 2003, 9,161 undergraduate students attending a large, public, midwestern research university in the United States self-administered a Web-based survey. The prevalence rate for illicit use within the past year was highest for pain medication, followed by stimulant medication, sedative or anxiety medication, and sleeping medication. Women generally reported higher past-year medical use rates. However, undergraduate men reported higher illicit use rates. The illicit use-medical use ratio for stimulant medication was the highest among the 4 classes of prescription drugs. Medical users of stimulants for attention deficit hyperactivity disorder were the most likely to be approached to divert their medication. Multivariate results indicated that illicit users of prescription drugs were more likely to use other drugs than were students who did not use prescription drugs illicitly. The authors provide evidence that prescription drug abuse is a problem among college students.

McCabe, Sean Esteban; Boyd, Carol J.; Teter, Chrisian J.

2006-01-01

139

How Medicare Prescription Drug Coverage Works with a Medicare Advantage Plan or Medicare Cost Plan  

MedlinePLUS

How Medicare Prescription Drug Coverage Works with a Medicare Advantage Plan or Medicare Cost Plan Revised April 2013 Medicare offers prescription ... MA-PDs.” You’ll get all of your Medicare coverage (Part A and Part B), including prescription ...

140

77 FR 1877 - Medicare Program; Medicare Advantage and Prescription Drug Benefit Programs: Negotiated Pricing...  

Federal Register 2010, 2011, 2012, 2013

...applies only to prescription drug plans (PDPs), and not...qualified retiree prescription drug plans (QRPDP). However, given the fact that this waiver authority...subsidy is an after- the-fact subsidy; meaning that the drug costs are incurred...

2012-01-12

141

Anti-asthmatic drug prescriptions to an Italian paedriatic population.  

PubMed

To estimate the prevalence and evaluate the appropriateness of anti-asthmatic drug prescriptions in an Italian paediatric population, drug prescriptions involving 24,407 children <18 years old, dispensed during 2003 by the retail pharmacies of the local health unit in Lecco, Italy, were analysed. Children > or = 6 years old receiving anti-asthmatics were categorized into three subgroups based on the number of boxes prescribed: occasional (one box), low (two and three boxes) and high (> or = four boxes) users. A logistic regression analysis was performed to estimate the relationship between the drug use patterns and formulations, antibiotic co-prescriptions, systemic steroid prescriptions and rate of hospitalization. Anti-asthmatic drugs were prescribed to 6594 (12%) children and adolescents; 58% of whom received only one box of the drug. Prevalence varied according to age, with the highest values at 1 and 4 years (24% and 21% respectively), and decreased to 6% in 17-year-old adolescents. Inhaled steroids were the most prescribed drugs (83%). The most common of these was beclomethasone. Occasional, low and high users represented 58%, 29%, and 13%, respectively, of the treated population > or = 6 years old. High users were found to be at increased risk of systemic steroid prescriptions (OR 8.6) and hospital admission for asthma (OR 6.8). This study confirms that in Italy the prevalence of anti-asthmatic prescription is much higher than prevalence of disease, indicating that anti-asthmatics are over-prescribed. Moreover, steroids, especially nebulized, are mainly prescribed only once in a year, supporting the idea that are prescribed not for asthma, which as chronic disease requires a chronic therapy. The approach to create subgroups on the basis of number of boxes prescribed seems to be effective in estimating asthma severity and appropriateness of the therapies. PMID:18771473

Bianchi, Marina; Clavenna, Antonio; Labate, Lorena; Bortolotti, Angela; Fortino, Ida; Merlino, Luca; Locatelli, G Walter; Giuliani, Gianemilio; Bonati, Maurizio

2008-09-03

142

public service announcment - prescription drugs - female ...  

Center for Drug Evaluation (CDER)

Text Version... Have questions? Ask your pharmacist. A message from the US Department of Health and Human Services - Food and Drug Administration. ... More results from www.fda.gov/downloads/drugs/resourcesforyou

143

Truthful Prescription Drug Advertising and Promotion  

Center for Drug Evaluation (CDER)

... Example of Overstating the Effectiveness. “Doctor Smith, Drug X delivers rapid results in as little as 3 days.”. This presentation ... More results from www.fda.gov/drugs/guidancecomplianceregulatoryinformation/surveillance

144

Drug overdose due to malfunction of a patient-controlled analgesia machine -A case report-.  

PubMed

Patient-controlled analgesia (PCA) provides excellent pain control and high stability, thereby minimizing the incidence of adverse effects. However, one of our patients experienced respiratory depression and hypotension within 30 minutes of initiation of PCA therapy. We discovered that machine malfunction caused continuous activation of the PCA button, resulting in a drug overdose. The PCA machine was sent to the manufacturer, who found an electrical short in the PCA button. All PCA units of the same make and model were immediately removed from hospitals and replaced with redesigned units without defects in the PCA button. We have used the improved machines without any problems. The purpose of this report is to raise awareness of this type of malfunction in PCA units in order to help prevent adverse events in the future. PMID:23560197

Yi, Yuri; Kang, Seongsik; Hwang, Byeongmun

2013-03-19

145

Estimating the Effects of Prescription Drug Coverage for Medicare Beneficiaries  

PubMed Central

Objective To identify the effect of insurance coverage on prescription utilization by Medicare beneficiaries. Data Sources/Study Setting Secondary data from the 1999 Medicare Current Beneficiary Survey (MCBS) Cost and Use files, a nationally representative survey of Medicare enrollees. Study Design The paper uses a cross-sectional design with (1) a standard regression framework to estimate the impact of prescription coverage on utilization controlling for potential selection bias with covariate control based on the Diagnostic Cost Group/Hierarchical Condition Category (DCG/HCC) risk adjuster, and (2) a multistage residual inclusion method using instrumental variables to control for selection bias and identify the insurance coverage effect. Data Collection/Extraction Methods Data were extracted from the 1999 MCBS. Study inclusion criteria are community-dwelling MCBS respondents with full-year Medicare enrollment and supplemental medical insurance with or without full-year drug benefits. The final sample totaled 5,270 Medicare beneficiaries. Principal Findings Both the model using the DCG/HCC risk adjuster and the model using the residual inclusion method produced similar results. The estimated price elasticity of demand for prescription drugs for the Medicare beneficiaries in our sample was ?0.54. Conclusions Our results confirm that selection into prescription coverage is predictable based on observable health. Our results further confirm prior estimates of price sensitivity of prescription drug demand for Medicare beneficiaries, though our estimate is slightly above prior results.

Shea, Dennis G; Terza, Joseph V; Stuart, Bruce C; Briesacher, Becky

2007-01-01

146

76 FR 2691 - Prescription Drug Products Containing Acetaminophen; Actions To Reduce Liver Injury From...  

Federal Register 2010, 2011, 2012, 2013

...overdose can cause liver damage (hepatotoxicity), ranging in severity from abnormalities...the following as a boxed warning: Hepatotoxicity [DRUG NAME] contains acetaminophen...Larson, A.M., ``Acetaminophen Hepatotoxicity,'' Clinical Liver Disease,...

2011-01-14

147

A New Prescription for Fighting Drug Abuse  

ERIC Educational Resources Information Center

|It's a drug prevention conversation--and program--that was largely missing as recently as a decade ago in most middle and high schools. In those days, the principal concern of health educators and disciplinarians alike was to keep students from misusing alcohol and illegal street drugs such as ecstasy, cocaine and even heroine. But driven by the…

Schachter, Ron

2012-01-01

148

Basic Models for Mapping Prescription Drug Data  

Microsoft Academic Search

Geographic patterns of diseases across time are of critical interest for public health monitoring and policy. Availability of information from which to derive estimates of disease patterns, however, is generally very limited, either in terms of geographic or population coverage, or both. By contrast, availability of information on pharmaceutical drug dispensing is very robust. Pharmaceutical drug information, although not directly

Kennon R. Copeland; A. Elizabeth Allen

2004-01-01

149

A New Prescription for Fighting Drug Abuse  

ERIC Educational Resources Information Center

It's a drug prevention conversation--and program--that was largely missing as recently as a decade ago in most middle and high schools. In those days, the principal concern of health educators and disciplinarians alike was to keep students from misusing alcohol and illegal street drugs such as ecstasy, cocaine and even heroine. But driven by the…

Schachter, Ron

2012-01-01

150

Community-based opioid overdose prevention programs providing naloxone - United States, 2010.  

PubMed

Drug overdose death rates have increased steadily in the United States since 1979. In 2008, a total of 36,450 drug overdose deaths (i.e., unintentional, intentional [suicide or homicide], or undetermined intent) were reported, with prescription opioid analgesics (e.g., oxycodone, hydrocodone, and methadone), cocaine, and heroin the drugs most commonly involved . Since the mid-1990s, community-based programs have offered opioid overdose prevention services to persons who use drugs, their families and friends, and service providers. Since 1996, an increasing number of these programs have provided the opioid antagonist naloxone hydrochloride, the treatment of choice to reverse the potentially fatal respiratory depression caused by overdose of heroin and other opioids. Naloxone has no effect on non-opioid overdoses (e.g., cocaine, benzodiazepines, or alcohol) . In October 2010, the Harm Reduction Coalition, a national advocacy and capacity-building organization, surveyed 50 programs known to distribute naloxone in the United States, to collect data on local program locations, naloxone distribution, and overdose reversals. This report summarizes the findings for the 48 programs that completed the survey and the 188 local programs represented by the responses. Since the first opioid overdose prevention program began distributing naloxone in 1996, the respondent programs reported training and distributing naloxone to 53,032 persons and receiving reports of 10,171 overdose reversals. Providing opioid overdose education and naloxone to persons who use drugs and to persons who might be present at an opioid overdose can help reduce opioid overdose mortality, a rapidly growing public health concern. PMID:22337174

2012-02-17

151

Use of analgesics in intentional drug overdose presentations to hospital before and after the withdrawal of distalgesic from the Irish market  

PubMed Central

Background Distalgesic, the prescription-only analgesic compound of paracetamol (325 mg) and dextropropoxyphene (32.5 mg) known as co-proxamol in the UK, was withdrawn from the Irish market as of January 2006. This study aimed to evaluate the impact of the withdrawal of distalgesic in terms of intentional drug overdose (IDO) presentations to hospital emergency departments (EDs) nationally. Methods A total of 42,849 IDO presentations to 37 of the 40 hospitals EDs operating in Ireland in 2003-2008 were recorded according to standardised procedures. Data on sales of paracetamol-containing drugs to retail pharmacies for the period 1998-2008 were obtained from IMS Health. Results The withdrawal of distalgesic from the Irish market resulted in an immediate reduction in sales to retail pharmacies from 40 million tablets in 2005 to 500,000 tablets in 2006 while there was a 48% increase in sales of other prescription compound analgesics. The rate of IDO presentations to hospital involving distalgesic in 2006-2008 was 84% lower than in the three years before it was withdrawn (10.0 per 100,000). There was a 44% increase in the rate of IDO presentations involving other prescription compound analgesics but the magnitude of this rate increase was five times smaller than the magnitude of the decrease in distalgesic-related IDO presentations. There was a decreasing trend in the rate of presentations involving any paracetamol-containing drug that began in the years before the distalgesic withdrawal. Conclusions The withdrawal of distalgesic has had positive benefits in terms of IDO presentations to hospital in Ireland and provides evidence supporting the restriction of availability of means as a prevention strategy for suicidal behaviour.

2010-01-01

152

Non-medical use of prescription drugs and sexual risk behavior in young adults  

Microsoft Academic Search

In recent years, the non-medical use of prescription drugs (without a doctor's prescription) has increased dramatically, particularly in young adults. Previous work has noted associations between the non-medical use of prescription drugs and the use of illicit drugs, and associations between the use of illicit drugs and sexual risk behavior. Investigations examining associations between the non-medical use of prescription drugs

Eric G. Benotsch; Stephen Koester; Diana Luckman; Aaron M. Martin; Anna Cejka

2011-01-01

153

Oh Canada!: Antitrust Geographic Market Definition and the Reimportation of Prescription Drugs  

Microsoft Academic Search

In recent years, public attention has focused on the need for affordable prescription drugs. Although Congress has recently enacted a Medicare Prescription Drug Plan, many private citizens and state and local governments continue to reimport prescription drugs from Canada to take advantage of the lower drug prices available in Canada. Many pharmaceutical companies have responded to this phenomenon by cutting

Maryan M Chirayath

2005-01-01

154

Prescription and Over-the-Counter Drug Abuse Prevention. Prevention Update  

ERIC Educational Resources Information Center

|According to the White House Office of National Drug Control Policy, "abuse of prescription drugs to get high has become increasingly prevalent among teens and young adults. Past year abuse of prescription pain killers now ranks second--only behind marijuana--as the Nation's most prevalent illegal drug problem." Use of prescription drugs without…

Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2010

2010-01-01

155

A Political History of Medicare and Prescription Drug Coverage  

PubMed Central

This article examines the history of efforts to add prescription drug coverage to the Medicare program. It identifies several important patterns in policymaking over four decades. First, prescription drug coverage has usually been tied to the fate of broader proposals for Medicare reform. Second, action has been hampered by divided government, federal budget deficits, and ideological conflict between those seeking to expand the traditional Medicare program and those preferring a greater role for private health care companies. Third, the provisions of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 reflect earlier missed opportunities. Policymakers concluded from past episodes that participation in the new program should be voluntary, with Medicare beneficiaries and taxpayers sharing the costs. They ignored lessons from past episodes, however, about the need to match expanded benefits with adequate mechanisms for cost containment. Based on several new circumstances in 2003, the article demonstrates why there was a historic opportunity to add a Medicare prescription drug benefit and identify challenges to implementing an effective policy.

Oliver, Thomas R; Lee, Philip R; Lipton, Helene L

2004-01-01

156

Justice Implications of a Proposed Medicare Prescription Drug Policy  

ERIC Educational Resources Information Center

|Social justice is a core value to the mission of social work. Older people are among the most vulnerable populations for whom social workers are called on to advocate. Although Medicare prescription drug coverage has been a top legislative issue over the past few years, such a benefit expansion has yet to be implemented. This article examines the…

Larkin, Heather

2004-01-01

157

A defense of direct-to-consumer prescription drug advertising  

Microsoft Academic Search

Within the past 20 years, consumer advertising of prescription drugs has grown from a rarity to one of the most pervasive forms of consumer advertising, with ads for antidepressants and heart medications now as common as those for fast food and automobiles. At the same time, direct-to-consumer (DTC) advertising has attracted a growing chorus of criticism from consumer advocates, health

Anthony D. Cox; Dena Cox

2010-01-01

158

Rural Adolescents' Nonmedical Prescription Drug Use: Implications for Intervention  

ERIC Educational Resources Information Center

|Rural communities often have distinct contextual factors that impact residents' substance abuse behavior. However, most studies to date have focused either exclusively on urban populations or neglected to analyze data in a way that allows any rural/urban comparison. This is especially true for research examining nonmedical prescription drug use…

Young, April M.; Glover, Natalie; Havens, Jennifer R.

2012-01-01

159

Combating Misuse and Abuse of Prescription Drugs  

MedlinePLUS

... of substances covered by the Controlled Substances Act (CSA). In addition, FDA can become aware that a ... informed and may schedule the drug under the CSA. Q: What are the keys to preventing abuse ...

160

Prescription Drug Information for Patients: History  

Center for Drug Evaluation (CDER)

Text Version... Specific population information (ie, not studied in children younger than 4) Page 10. 9 ... Consumer (DTC) Television and Print Advertisements for ... More results from www.fda.gov/downloads/drugs/newsevents

161

Prescription Drug Information for Patients: History  

Center for Drug Evaluation (CDER)

Text Version... workflow • Cost Page 6. Current State Research & Evaluation • Lack of evidence base for usefulness or effectiveness of current written information ... More results from www.fda.gov/downloads/drugs/newsevents

162

Letters to Doctors about Suspect Prescription Drugs ...  

Center for Drug Evaluation (CDER)

... On February 5, 2013, FDA alerted health care professionals about a counterfeit unapproved cancer medicine distributed by a US company, Medical ... More results from www.fda.gov/drugs/drugsafety/drugintegrityandsupplychainsecurity

163

Prescription Drug Abuse Among Adolescent Arrestees: Correlates and Implications  

Microsoft Academic Search

This preliminary study examines the correlates of prescription drug abuse in a sample of adolescents in an urban juvenile detention center in Ohio. The study measures risk in 359 incarcerated females (20.1%) and 1,425 males (79.9%) by asking questions related to problems with alcohol, drug use, treatment history, mental and physical health problems, sexual behavior, anger management, physical violence, and

Sonia A. Alemagno; Peggy Stephens; Peggy Shaffer-King; Brent Teasdale

2009-01-01

164

Health Outcomes in Patients Using No-Prescription Online Pharmacies to Purchase Prescription Drugs  

PubMed Central

Background Many prescription drugs are freely available for purchase on the Internet without a legitimate prescription from a physician. Objective This study focused on the motivations for using no-prescription online pharmacies (NPOPs) to purchase prescription drugs rather than using the traditional doctor-patient-pharmacy model. We also studied whether users of NPOP-purchased drugs had poorer health outcomes than those who obtain the same drug through legitimate health care channels. Methods We selected tramadol as a representative drug to address our objective because it is widely prescribed as an unscheduled opioid analgesic and can easily be purchased from NPOPs. Using search engine marketing (SEM), we placed advertisements on search result pages stemming from the keyword “tramadol” and related terms and phrases. Participants, who either used the traditional doctor-patient-pharmacy model to obtain tramadol (traditional users, n=349) or purchased it on the Web without a prescription from their local doctor (ie, nontraditional users, n=96), were then asked to complete an online survey. Results Respondents in both groups were primarily white, female, and in their mid-forties (nontraditional users) to upper forties (traditional users). Nearly all nontraditional users indicated that their tramadol use was motivated by a need to treat pain (95%, 91/96) that they perceived was not managed appropriately through legitimate health care channels. A majority of nontraditional users (55%, 41/75) indicated they used NPOPs because they did not have access to sufficient doses of tramadol to relieve pain. In addition, 29% (22/75) of nontraditional users indicated that the NPOPs were a far cheaper alternative than seeing a physician, paying for an office visit, and filling a prescription at a local pharmacy, which is often at noninsured rates for those who lack medical insurance (37%, 35/96, of NPOP users). The remainder of participants (16%, 12/96) cited other motivations (eg, anonymity) for using NPOPs. In terms of health outcomes, nontraditional users experienced a significantly (P<.01) greater number and severity of adverse events, including life-threatening seizures: 7% (7/96) of nontraditional users reported seizures, while none of the traditional users reported seizures. Conclusions Although online pharmacies can offer distinct advantages in terms of convenience and cost, users of these “rogue” pharmacies that offer drugs with no prescription or doctor supervision do so at great risk to their health, as evidenced by much higher rates of adverse events. The most logical explanation for these findings is that the lack of physician oversight of dosage schedules, contraindicated conditions, and concomitant medications, were responsible for the increased intensity and frequency of adverse events in the nontraditional users. Although we only examined tramadol, it is logical to postulate that similar results would be observed with dozens of equally accessible prescription drugs. As such, the geometric growth in the use of online pharmacies around the world should prompt intense medical and regulatory discussion about their role in the provision of medical care.

2012-01-01

165

"Gender-specific drug prescription in Germany" results from prescriptions analyses.  

PubMed

There are still considerable differences in the medication supply for men and women. While the prescription volumes for both men and women have, for some time, been similar or have even risen for the men, there are still characteristic differences between the sexes when it comes to the prescription of certain indication groups. Women are still prescribed clearly more drugs in the field of psychotropic medication, especially antidepressants, hypnotic drugs, and tranquilisers. As the American Beers criteria for quite some time now and, more recently, the German PRISCUS list have shown, the effects of such drugs are potentially dangerous, particularly for older women. The known adverse effects are, apart from dependence problems, restricted cognitive capacities, insecure or instable walking, and badly healing wounds from falling accidents that are followed by patient's nursing care dependency. In secondary prophylaxis after acute myocardial infarction, the characteristic prescription features of the various medicinal products that are used for both men and women (such as platelet aggregation inhibitors, beta-receptor blockers, ACE-inhibitors, statins) have become similar; women's still higher mortality risk appears to go back to the fact that too much time is spent before proper hospital treatment commences. In general, more attention should be paid to the right medication, the right length of treatment, and the right dosage of the medication prescribed to women; the evidence concerning women's supply of medicinal products should also be improved. PMID:23027450

Glaeske, Gerd; Gerdau-Heitmann, Cornelia; Höfel, Friederike; Schicktanz, Christel

2012-01-01

166

State prescription drug price Web sites: how useful to consumers?  

PubMed

To aid consumers in comparing prescription drug costs, many states have launched Web sites to publish drug prices offered by local retail pharmacies. The current push to make retail pharmacy prices accessible to consumers is part of a much broader movement to increase price transparency throughout the health-care sector. Efforts to encourage price-based shopping for hospital and physician services have encountered widespread concerns, both on grounds that prices for complex services are difficult to measure and compare accurately and that quality varies substantially across providers. Experts agree, however, that prescription drugs are much easier to shop for than other, more complex health services. However, extensive gaps in available price information--the result of relying on Medicaid data--seriously hamper the effectiveness of state drug price-comparison Web sites, according to a new study by the Center for Studying Health System Change (HSC). An alternative approach--requiring pharmacies to submit price lists to the states--would improve the usefulness of price information, but pharmacies typically oppose such a mandate. Another limitation of most state Web sites is that price information is restricted to local pharmacies, when online pharmacies, both U.S. and foreign, often sell prescription drugs at substantially lower prices. To further enhance consumer shopping tools, states might consider expanding the types of information provided, including online pharmacy comparison tools, lists of deeply discounted generic drugs offered by discount retailers, and lists of local pharmacies offering price matches. PMID:18494180

Tu, Ha T; Corey, Catherine G

2008-02-01

167

Searching for answers: proper prescribing of controlled prescription drugs.  

PubMed

Prescription drug abuse is increasing at alarming rates in this country. Most often drugs are obtained through relatives or friends. An important step in addressing this problem is educating healthcare providers in the proper prescribing of scheduled drugs. Physicians and other healthcare workers receive little training in proper screening for substance abuse, proper prescribing of scheduled drugs, and referral for those needing treatment. Continuing medical education is one venue for addressing this problem. However, screening, brief intervention and referral for treatment (SBIRT) should be taught in medical school and residency. PMID:22641969

Brown, Martha E; Swiggart, William H; Dewey, Charlene M; Ghulyan, Marine V

168

Prescription Drug Spending by Medicare Beneficiaries in Institutional and Residential Settings, 1998-2001.  

National Technical Information Service (NTIS)

Although much attention has been paid to the potential implications of the Medicare Prescription Drug, Improvement, and Modernization Act of 2005 (MMA) on prescription drug utilization and expenditures for community-dwelling beneficiaries, less attention ...

B. Stuart L. Simoni-Wastila T. Shaffer

2007-01-01

169

42 CFR 423.464 - Coordination of benefits with other providers of prescription drug coverage.  

Code of Federal Regulations, 2010 CFR

...2010-10-01 2010-10-01 false Coordination of benefits with other providers...MEDICARE PRESCRIPTION DRUG BENEFIT Coordination of Part D Plans With Other Prescription...Drug Coverage § 423.464 Coordination of benefits with other...

2010-10-01

170

42 CFR 423.464 - Coordination of benefits with other providers of prescription drug coverage.  

Code of Federal Regulations, 2010 CFR

...2009-10-01 2009-10-01 false Coordination of benefits with other providers...MEDICARE PRESCRIPTION DRUG BENEFIT Coordination of Part D Plans With Other Prescription...Drug Coverage § 423.464 Coordination of benefits with other...

2009-10-01

171

Calcium channel blocker overdose  

MedlinePLUS

Salhanick SD. Calcium channel antagonists. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap ...

172

Cardiac glycoside overdose  

MedlinePLUS

Lapostolle F, Borron SW. Digitalis. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap ...

173

Naproxen sodium overdose  

MedlinePLUS

Naproxen sodium is a non-steroidal anti-inflammatory drug (NSAID) used to relieve mild to moderate aches and pains. Naproxen sodium overdose occurs when someone accidentally or intentionally takes ...

174

Retiree Health Benefits: Majority of Sponsors Continued to Offer Prescription Drug Coverage and Chose the Retiree Drug Subsidy.  

National Technical Information Service (NTIS)

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) created a prescription drug benefit for beneficiaries, called Medicare Part D, beginning in January 2006. The MMA resulted in options for sponsors of employment-based prescri...

2007-01-01

175

Variation in prescription of lipid lowering drugs: variation between general practices  

Microsoft Academic Search

Background: Lipid lowering drugs are frequently prescribed and expensive drugs. The prescription of lipid lowering drugs has strongly increased over the last few years. However, variation in prescription between general practitioners (GPs) is substantial. Aim: The aim of the study is to find out how prescription behavior of GPs combined with characteristics of patients leads to variation in prescribing lipid

L. van Dijk; H. van Lindert; G. Westert

2003-01-01

176

Income and the use of prescription drugs for near retirement individuals  

Microsoft Academic Search

Understanding how demand for prescription drugs responds to changes in income is important for assessing the welfare consequences of reforms affecting income. This becomes more imminent as age progresses, because the use of prescription drugs and the associated budgetary burden increases dramatically from about age 55. In this paper we estimate how demand for prescription drugs varies with income for

Søren Leth-Petersen; Niels Skipper

2010-01-01

177

Prescription and over-the-counter drug treatment admissions to the California public treatment system  

Microsoft Academic Search

Prescription and over-the-counter (OTC) drug abuse has become a focal point of public health policy, prevention, and control efforts. Adolescents represent one of the fastest growing segments of the general population abusing prescription and OTC drugs as represented by national surveys. This article reports on treatment admission data to the California addiction public system for prescription and OTC drugs among

Rachel Gonzales; Mary-Lynn Brecht; Larissa Mooney; Richard A. Rawson

2011-01-01

178

Nonmedical Prescription Drug Use Among College Students: A Comparison Between Athletes and Nonathletes  

Microsoft Academic Search

Objective: Given the substantial increase in nonmedical prescription drug use in recent years and a lack of research on the topic, the author analyzed data on nonmedical prescription drug use among college students. Participants and Methods: Using data from the 2001 College Alcohol Study (N = 10,904), the author examined variation in nonmedical prescription drug use on the basis of

Jason A. Ford

2008-01-01

179

77 FR 45639 - Prescription Drug User Fee Rates for Fiscal Year 2013  

Federal Register 2010, 2011, 2012, 2013

...FDA-2012-N-0007] Prescription Drug User Fee Rates for Fiscal Year 2013 AGENCY: Food...announcing the rates for prescription drug user fees for fiscal year (FY) 2013. The Federal...as amended by the Prescription Drug User Fee Amendments of 2012 (Title 1 of the...

2012-08-01

180

76 FR 45831 - Prescription Drug User Fee Rates for Fiscal Year 2012  

Federal Register 2010, 2011, 2012, 2013

...FDA-2011-N-0559] Prescription Drug User Fee Rates for Fiscal Year 2012 AGENCY: Food...announcing the rates for prescription drug user fees for fiscal year (FY) 2012. The Federal...as amended by the Prescription Drug User Fee Amendments of 2007 (Title 1 of the...

2011-08-01

181

75 FR 46952 - Prescription Drug User Fee Rates for Fiscal Year 2011  

Federal Register 2010, 2011, 2012, 2013

...FDA-2010-N-0390] Prescription Drug User Fee Rates for Fiscal Year 2011 AGENCY: Food...announcing the rates for prescription drug user fees for fiscal year (FY) 2011. The Federal...as amended by the Prescription Drug User Fee Amendments of 2007 (Title 1 of the...

2010-08-04

182

On the demand for prescription drugs: heterogeneity in price responses.  

PubMed

This paper estimates the price elasticity of demand for prescription drugs using an exogenous shift in consumer co-payment caused by a reform in the Danish subsidy scheme for the general public. Using purchasing records for the entire Danish population, I show that the average price response for the most commonly used drug yields demand elasticities in the range of -0.36 to -0.5. The reform is shown to affect women, the elderly, and immigrants the most. Furthermore, this paper shows significant heterogeneity in the price response over different types of antibiotics, suggesting that the price elasticity of demand varies considerably even across relatively similar drugs. PMID:22899231

Skipper, Niels

2012-08-16

183

Gender-Based Differences in Drug Prescription: Relation to Adverse Drug Reactions  

Microsoft Academic Search

Background\\/Aim: The female gender appears to suffer from more adverse drug reactions (ADRs) than the male gender. So far, there has been no epidemiologic study analyzing gender-based differences in drug prescribing and its ADR risks. The aim of the present study was to establish a drug risk stratification adjusted to age, number of prescriptions and drug classes with respect to

Y. Zopf; C. Rabe; A. Neubert; C. Janson; K. Brune; E. G. Hahn; H. Dormann

2009-01-01

184

Community Characteristics and Death by Homicide, Suicide and Drug Overdose in Italy: The Role of Civic Engagement  

Microsoft Academic Search

A number of recent theories suggest that high civicness, civic participation and social capital protect a community from deviant\\u000a behavior. Most empirical studies of this hypothesis have been conducted in North America. This paper examines to what extent\\u000a this hypothesis applies to Italy and to three forms of violent death: homicide, suicide, and drug overdose, using the Putnam\\u000a concept of

Uberto Gatti; Richard E. Tremblay; Hans M. A. Schadee

2007-01-01

185

Direct-to-Consumer Prescription Drug Advertising and the Public  

PubMed Central

OBJECTIVE Drug manufacturers are intensely promoting their products directly to consumers, but the impact has not been widely studied. Consumers' awareness and understanding of, attitudes toward, and susceptibility to direct-to-consumer (DTC) drug advertising were examined. DESIGN Random-digit dialing telephone survey with a random household member selection procedure (completion and response rates, 58% and 69%, respectively). SETTING Respondents were interviewed while they were at their residences. PARTICIPANTS Complete data were obtained from 329 adults in Sacramento County, California. MEASUREMENTS AND MAIN RESULTS Outcome measures included awareness of advertisements for 10 selected drugs, misconceptions about DTC advertising, attitudes toward DTC ads, and behavioral responses to such promotions. The influence of demographic characteristics, health status, attitudes, beliefs, and media exposure on awareness and behaviors was examined. On average, respondents were aware of advertisements for 3.7 of the 10 drugs; awareness varied from 8% for Buspar (buspirone) to 72% for Claritin (loratadine). Awareness was associated with prescription drug use, media exposure, positive attitudes toward DTC advertising, poorer health, and insurance status. Substantial misconceptions were revealed; e.g., 43% thought that only “completely safe” drugs could be advertised. Direct-to-consumer advertisements had led one third of respondents to ask their physicians for drug information and one fifth to request a prescription. CONCLUSIONS Direct-to-consumer advertisements are reaching the public, but selectively so, and affecting their behaviors. Implications for public policy are examined.

Bell, Robert A; Kravitz, Richard L; Wilkes, Michael S

1999-01-01

186

Prescription Drug Labeling Medication Errors: A Big Deal for Pharmacists  

PubMed Central

Today, in the health care profession, all types of medication errors including missed dose, wrong dosage forms, wrong time interval, wrong route, etc., are a big deal for better patient care. Today, problems related to medications are common in the healthcare profession, and are responsible for significant morbidity, mortality, and cost. Several recent studies have demonstrated that patients frequently have difficulty in reading and understanding medication labels. According to the Institute of Medicine report, “Preventing Medication Errors”, cited poor labeling as a central cause for medication errors in the USA. Evidence suggests that specific content and format of prescription drug labels facilitate communication with and comprehension by patients. Efforts to improve the labels should be guided by such evidence, although an additional study assessing the influence of label design on medication-taking behavior and health outcomes is needed. Several policy options exist to require minimal standards to optimize medical therapy, particularly in light of the new Medicare prescription drug benefit.

Jeetu, G; Girish, T

2010-01-01

187

Abuse\\/misuse of non?prescription drugs  

Microsoft Academic Search

Aim: To investigate the abuse of non-prescription (over-the-counter; OTC) products in Northern Ireland. Method: A structured questionnaire covering various aspects of OTC drug abuse was mailed to all 509 community pharmacies in Northern Ireland. Results: 253 responses were received (response rate 49.7%) after two mailings. Pharmacists named 112 OTC products they perceived were being abused in Northern Ireland. These were

Glenda F. Hughes; James C. McElnay; Carmel M. Hughes; Patricia McKenna

1999-01-01

188

National drug control policy and prescription drug abuse: facts and fallacies.  

PubMed

In a recent press release Joseph A. Califano, Jr., Chairman and President of the National Center on Addiction and Substance Abuse at Columbia University called for a major shift in American attitudes about substance abuse and addiction and a top to bottom overhaul in the nation's healthcare, criminal justice, social service, and eduction systems to curtail the rise in illegal drug use and other substance abuse. Califano, in 2005, also noted that while America has been congratulating itself on curbing increases in alcohol and illicit drug use and in the decline in teen smoking, abuse and addition of controlled prescription drugs-opioids, central nervous system depressants and stimulants-have been stealthily, but sharply rising. All the statistics continue to show that prescription drug abuse is escalating with increasing emergency department visits and unintentional deaths due to prescription controlled substances. While the problem of drug prescriptions for controlled substances continues to soar, so are the arguments of undertreatment of pain. The present state of affairs show that there were 6.4 million or 2.6% Americans using prescription-type psychotherapeutic drugs nonmedically in the past month. Of these, 4.7 million used pain relievers. Current nonmedical use of prescription-type drugs among young adults aged 18-25 increased from 5.4% in 2002 to 6.3% in 2005. The past year, nonmedical use of psychotherapeutic drugs has increased to 6.2% in the population of 12 years or older with 15.172 million persons, second only to marijuana use and three times the use of cocaine. Parallel to opioid supply and nonmedical prescription drug use, the epidemic of medical drug use is also escalating with Americans using 80% of world's supply of all opioids and 99% of hydrocodone. Opioids are used extensively despite a lack of evidence of their effectiveness in improving pain or functional status with potential side effects of hyperalgesia, negative hormonal and immune effects, addiction and abuse. The multiple reasons for continued escalation of prescription drug abuse and overuse are lack of education among all segments including physicians, pharmacists, and the public; ineffective and incoherent prescription monitoring programs with lack of funding for a national prescription monitoring program NASPER; and a reactive approach on behalf of numerous agencies. This review focuses on the problem of prescription drug abuse with a discussion of facts and fallacies, along with proposed solutions. PMID:17525776

Manchikanti, Laxmaiah

2007-05-01

189

The context of illicit drug overdose deaths in British Columbia, 2006  

PubMed Central

Background Illicit drug overdose deaths (IDD) relate to individual drug dose and context of use, including use with other drugs and alcohol. IDD peaked in British Columbia (BC) in 1998 with 417 deaths, and continues to be a public health problem. The objective of this study was to examine IDD in 2006 in BC by place of residence, injury and death, decedents' age and sex and substances identified. Methods IDD data was obtained through the BC Coroners Office and entered into SPSS (version 14). Fisher's exact and Pearson's ?2 were used for categorical data; Mann-Whitney U-test for continuous variables. Rates were calculated using 2006 population estimates. Results We identified 223 IDD in BC; 54 (24%) occurred in Vancouver. Vancouver decedents (compared to those occurring outside Vancouver) were older (mean age 43.9 vs. 39.2 years; p < 0.01) and more likely to be male (90.7% vs. 77.5%; p = 0.03). Provincially Aboriginal ethnicity was reported for 19 deaths; 13 (30.2%) of 43 females and 6 (3.3%) of 180 males (p = < 0.001). Cocaine was identified in 80.3%, opiates 59.6%, methadone 13.9%, methamphetamine/amphetamine 6.3%, and alcohol in 22.9% of deaths. Poly-substance use was common, 2 substances were identified in 43.8% and 3 or more in 34.5% of deaths. Opiates were more frequently identified in Vancouver compared to outside Vancouver (74.1% vs. 55.0%) p = 0.015. Conclusion Collaboration with the Coroner's office allowed us to analyze IDD in detail including place of death; cocaine, opiates and poly-substance use were commonly identified. Poly-substance use should be explored further to inform public health interventions.

Buxton, Jane A; Skutezky, Trevor; Tu, Andrew W; Waheed, Bilal; Wallace, Alex; Mak, Sunny

2009-01-01

190

Suicide by captopril overdose.  

PubMed

We report a case of a 75 year-old male who committed suicide by taking an overdose of captopril. He took approximately ninety 12.5 mg captopril tablets. The postmortem plasma concentration of captopril was 60.4 mg/L. A review of the medical literature revealed five cases of captopril overdose all from unsuccessful suicide attempts. To our knowledge, this is the first case report of fatal captopril overdose with the measurement of plasma concentration of the drug. PMID:2231837

Park, H; Purnell, G V; Mirchandani, H G

1990-01-01

191

78 FR 8446 - Center for Drug Evaluation and Research; Prescription Drug Labeling Improvement and Enhancement...  

Federal Register 2010, 2011, 2012, 2013

...by facilitating optimal communication through labeling. FDA is...reducing the likelihood of medication errors. FDA implemented...prescription drug labeling as a communication tool and to discuss strategies...voluntary approach to enhance communication of information about...

2013-02-06

192

Prescription drug misuse, illicit drug use, and their potential risk and protective correlates in a Hispanic college student sample.  

PubMed

Illicit substance use has increased in Hispanics. Recent trends also warrant focus on prescription drug misuse, given its increased prevalence among college students. The aims of this study were to assess prescription drug misuse and illicit drug use in Hispanic students, as well as potential theoretically and empirically based risk and protective factors. Hispanic students (n = 435; 59% female) from a U.S. university located on the border with México completed a sociodemographic survey, licit, illicit, and prescription drug use frequency questionnaires, an attitudes and beliefs about prescription drugs survey, the Short Acculturation Scale for Hispanics, the Depression, Anxiety, and Stress Scales, the Collectivist Coping Styles Measure, and the Multidimensional Scale of Perceived Social Support. A hierarchical logistic regression assessed prescription drug misuse predictors including demographics, licit/illicit substance use, attitudes toward prescription drug use, acculturation, distress symptoms, coping style, perceived social support, and the interaction between distress symptoms and acculturation. A negative binomial regression assessed predictors of past 30-day illegal drug use (the same predictors as the previous model except illicit drug use). Results indicated that positive attitudes toward prescription drugs, higher anxiety, and lower depressive symptomatology increased the odds of prescription drug misuse. Past 30-day alcohol use, positive attitudes toward prescription drugs, and higher acculturation predicted past 30-day illicit drug use. Prescription drug misuse was differentially associated with distress symptoms, whereas the convergence model of acculturation was supported regarding illegal drug use. Inconsistent with hypotheses, protective factors were not significantly associated with substance use. PMID:23750694

Cabriales, José Alonso; Cooper, Theodore V; Taylor, Thom

2013-06-01

193

76 FR 24901 - Request for Input To Inform a Possible Surgeon General Action on Prescription Drug Abuse in Youth  

Federal Register 2010, 2011, 2012, 2013

...1\\ Prescription drug abuse is defined here...medication without a prescription; in a way other than...interchangeably with ``nonmedical'' use, a term employed...ONDCP highlighted prescription drug abuse in its...

2011-05-03

194

National Estimates of Exposure to Prescription Drugs with Addiction Potential in Community-Dwelling Elders  

Microsoft Academic Search

The use of prescription drugs with addiction potential is an overlooked and growing problem among today's elderly. This paper provides national prevalence estimates of exposure to prescription drugs with addiction potential among community-dwelling elders and explores risk factors for such exposure. Using the Medicare Current Beneficiary Survey, a nationally-representative database of Medicare eligibles, we calculated the prevalence of abusable prescription

Linda Simoni-Wastila; Ilene H. Zuckerman; Puneet K. Singhal; Becky Briesacher; Van Doren Hsu

2006-01-01

195

Prescription and Over-the-Counter Drug Abuse Admissions. The DASIS Report.  

National Technical Information Service (NTIS)

Prescription and over-the-counter (OTC) drug abuse accounted for a small fraction (3 percent) of the 1.6 million admissions reported to the Treatment Episode Data Set (TEDS) in 1999. Prescription drugs in TEDS are grouped as follows: prescription narcotic...

2002-01-01

196

In vitro studies on the application of colloidal emulsion aphrons to drug overdose treatment.  

PubMed

Colloidal emulsion aphrons (CEAs) are considered as the micron-sized water-in-oil (W/O) emulsion-cores encapsulated by a "soapy shell" consisting of multi-layer surfactant molecules. In this dispersion, the emulsion-core sizes are mainly in 10-100 microm and that of the inner phase droplets are in 1-5 microm. CEAs not only behave analogously to emulsion liquid membrane (ELM) in extraction with advantages of high concentration ratio, counter-concentration extraction and combination of extraction with backwash together, but also have the large interface areas, easy scatteration and quick extraction which colloidal liquid aphrons (CLAs) possess. CEA extraction overcomes the restriction of partition equilibrium between the water and the oil phase that CLAs have. They have greater extraction capacity than CLAs. In this study, the application of CEAs to drug overdose treatment was studied using salicylic acid as the model drug, paraffin oil as the membrane phase, PEG-30 dipolyhydroxystearate (P135) as the hydrophobic surfactant, nonylphenol ethoxylate-10 (NP10) as the hydrophilic surfactant and NaOH solution as the receptor phase. Also some factors affecting the stability of this dispersion and extraction ratio were investigated. In order to prepare CEAs successfully, the concentrations of NP10 and P135 should be in 1.5-3.0% (w/v) and 0.25-1.0% (w/v), respectively, together with the ratio of the volume of oil phase to the volume of inner aqueous phase of CEAs, R(oi)> or =1:1. For the extraction of salicylic acid, the pH value of the feed phase was supposed to be lower than 2.0 and the suitable NaOH concentration of the receptor phase was higher than 0.02 mol/L. Under this condition, more than 98.7% of salicylic acid was transported into receptor phase in half a minute. PMID:16439075

Dai, Yujie; Deng, Tong; Lu, Fuping

2006-01-24

197

Maternal exposure to prescription and non-prescription Pharmaceuticals or drugs of abuse and risk of craniosynosto sis  

Microsoft Academic Search

Background The pre- and peri-natal drug exposures reported by women participating in a case-control study of children in Colorado were examined for association with infant craniosynostosis. Methods Mothers of case and control children underwent a standardized telephone inter- view and obstetric and newborn medical record review. The interview included questions on the use of prescription and non-prescription drugs, nutritional supplements,

Jacqueline S Gardner; Beatrice Guyard-Boileau; Beth W Alderman; Sandra K Fernbach; Carol Greenee; Ellen J Mangione

1998-01-01

198

Drug-related mortality and fatal overdose risk: pilot cohort study of heroin users recruited from specialist drug treatment sites in London.  

PubMed

Fatal overdose and drug-related mortality are key harms associated with heroin use, especially injecting drug use (IDU), and are a significant contribution to premature mortality among young adults. Routine mortality statistics tend to underreport the number of overdose deaths and do not reflect the wider causes of death associated with heroin use. Cohort studies could provide evidence for interpreting trends in routine mortality statistics and monitoring the effectiveness of strategies that aim to reduce drug-related deaths. We aimed to conduct a retrospective mortality cohort study of heroin users recruited from an anonymous reporting system from specialist drug clinics. Our focus was to test whether (1). specialist agencies would agree to participate with a mortality cohort study, (2). a sample could be recruited to achieve credible estimates of the mortality rate, and (3). ethical considerations could be met. In total, 881 heroin users were recruited from 15 specialist drug agencies. The overall mortality rate of the cohort of heroin users was 1.6 (95% confidence interval [CI], 1.1 to 2.2) per 100 person-years. Mortality was higher among males, heroin users older than 30 years, and injectors, but not significantly higher after adjustment in a Cox proportional hazard model. Among the 33 deaths, 17 (52%) were certified from a heroin/methadone or opiate overdose, 4 (12%) from drug misuse, 4 (12%) unascertained, and 8 (24%) unrelated to acute toxic effects of drug use. Overall, the overdose mortality rate was estimated to be at least 1.0 per 100 person-years. The standardized mortality ratio (SMR) was 17 times higher for female and male heroin users in the cohort compared to mortality in the non-heroin-using London population aged 15-59 years. The pilot study showed that these studies are feasible and ethical, and that specialist drug agencies could have a vital role to play in the monitoring of drug-related mortality. PMID:12791803

Hickman, Matthew; Carnwath, Zenobia; Madden, Peter; Farrell, Michael; Rooney, Cleone; Ashcroft, Richard; Judd, Ali; Stimson, Gerry

2003-06-01

199

National Estimates of Prescription Drug Utilization and Expenditures in Long-Term Care Facilities.  

National Technical Information Service (NTIS)

Although several studies have provided national estimates of prescription drug use by Medicare beneficiaries residing in nursing homes (NHs) and other long-term care facilities (LTCFs), there are no published estimates of expenditures for prescription med...

B. Stuart L. Simoni-Wastila T. Shaffer

2006-01-01

200

The federal regulation of prescription drug advertising and promotion.  

PubMed

Prescription drug advertising has been regulated by the Food and Drug Administration since 1962. In the past decade, pharmaceutical companies have employed new communication mechanisms to reach physicians and, with increasing frequency, consumers. Examples of physician-oriented promotional activities are medical symposia and teleconferences. Consumer-oriented efforts include press conferences, use of celebrity spokespeople, and direct-to-consumer advertising. The Food and Drug Administration has asserted its legal jurisdiction over these nontraditional promotional activities and is regulating them on a case-by-case basis. As nontraditional promotional efforts become more prevalent, the Food and Drug Administration's regulatory framework must be able to meet the challenges of a changing environment. PMID:2231998

Kessler, D A; Pines, W L

1990-11-14

201

21 CFR 203.50 - Requirements for wholesale distribution of prescription drugs.  

Code of Federal Regulations, 2013 CFR

21 Food and Drugs 4 2013-04-01...50 Section 203.50 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...GENERAL PRESCRIPTION DRUG MARKETING Wholesale Distribution...

2013-04-01

202

Diagnosis-Based Risk Adjustment for Medicare Prescription Drug Plan Payments  

Microsoft Academic Search

The 2003 Medicare Prescription Drug, Im­ ­ provem­ ent, and Modernization Act (MMA) created Medicare Part D, a voluntary pre­ scription drug benefit program­ . The ben­ efit is a governm­ ent subsidized prescription drug benefit within Medicare. This article focuses on the developm­ ent of the prescrip­ tion drug risk­adjustm­ ent m­ odel used to adjust paym­ ents to

John Robst; Jesse M. Levy; Melvin J. Ingber

2007-01-01

203

21 CFR 250.100 - Amyl nitrite inhalant as a prescription drug for human use.  

Code of Federal Regulations, 2013 CFR

...Prescription Status of Specific Drugs § 250.100 Amyl...inhalant as a prescription drug for human use. ...available over-the-counter for emergency use...Commissioner of Food and Drugs received reports of the abuse of this drug...

2013-04-01

204

The rise in prescription drug abuse: raising awareness in the dental community.  

PubMed

Prescription drugs classified as controlled dangerous substances are essential therapeutic modalities in treating a variety of healthcare conditions; however, their pleasurable side effects can appeal to patients for uses other than their intent. As a result, unfortunate consequences of prescription drug use can arise. Misuse or abuse of prescription drugs can contribute to addictive behaviors, serious health risks, and potentially, death. It is imperative that the dental community remains educated and informed of nationwide healthcare trends, and prescription drug abuse is no exception. Ethically, dentists should be able to respond in a manner that addresses the best interests of their patients. To respond appropriately, dentists need to understand the terminology of prescription drug abuse; be able to identify and describe the drugs most often misused or abused; be able to identify individuals who may be at risk for prescription drug abuse; and be prepared to manage patients at risk in the dental setting. PMID:21894872

Oakley, Marnie; O'Donnell, Jean; Moore, Paul A; Martin, James

205

Improving Patient Understanding of Prescription Drug Label Instructions  

PubMed Central

Background Patient misunderstanding of instructions on prescription drug labels is common and a likely cause of medication error and less effective treatment. Objective To test whether the use of more explicit language to describe dose and frequency of use for prescribed drugs could improve comprehension, especially among patients with limited literacy. Design Cross-sectional study using in-person, structured interviews. Patients Three hundred and fifty-nine adults waiting for an appointment in two hospital-based primary care clinics and one federally qualified health center in Shreveport, Louisiana; Chicago, Illinois; and New York, New York, respectively. Measurement Correct understanding of each of ten label instructions as determined by a blinded panel review of patients’ verbatim responses. Results Patient understanding of prescription label instructions ranged from 53% for the least understood to 89% for the most commonly understood label. Patients were significantly more likely to understand instructions with explicit times periods (i.e., morning) or precise times of day compared to instructions stating times per day (i.e., twice) or hourly intervals (89%, 77%, 61%, and 53%, respectively, ?prescription drug label instructions can improve patient comprehension. However, patients with limited literacy were more likely to misinterpret instructions despite use of more explicit language.

Davis, Terry C.; Federman, Alex D.; Bass, Pat F.; Jackson, Robert H.; Middlebrooks, Mark; Parker, Ruth M.

2008-01-01

206

[Quality assurance of drug prescription in primary health care. A new database software makes the drug therapy surveillance easier].  

PubMed

Quality assurance of drug prescription is a pre-requisite for rational drug use. From 22 health-care centres in the south-western area of the Stockholm County Council region, drug-prescription data were obtained from the patients' computerised medical recordings. This could be done with the aid of a specially designed database program. The drug-prescription data from the 22 health-care centres were collected and compiled in a central unit. Thereafter the results were brought back to the health-care centres, in which the quality assurance of drug prescription could be started. PMID:11789100

Engfeldt, P; Popa, C; Bergensand, P; Bernsten, C; Lindgren, O; Navay, I; Sjöqvist, F; Svensson, E; Stenström, P; Tomson, Y; Aberg, H; Bergman, U

2001-12-12

207

A free market solution for prescription drug crises.  

PubMed

The cost of prescription drugs is imposing an ever greater burden on families and varying levels of government. The vast majority of this cost is attributable to patent protection, since most drugs are actually relatively cheap to produce. The temporary monopolies provided by patent protection have been the main mechanism through which corporations have financed their drug research. This article examines the efficiency of publicly supported drug research relative to the current patent system. The author shows that even if publicly funded research were considerably less efficient on a dollar-per-dollar basis than patent-supported research, there would still be enormous gains from switching to a system of publicly supported research. The main reason for this conclusion is that patent monopolies lead to enormous economic distortions, including expensive sales promotion efforts, research into "copycat drugs," incentives to conceal unfavorable research findings, and other inefficiencies that economic theory predicts would result from a government-created monopoly. The gains from publicly supported research, coupled with a free market in the production of drugs, could reach into several hundred billion dollars annually within a decade. PMID:15346683

Baker, Dean

2004-01-01

208

Prescribing practices and the prescription drug epidemic: physician intervention strategies.  

PubMed

Prescription drug abuse is increasingly recognized as the United States' fastest growing drug problem, rising dramatically since the early 2000s, and particularly affecting adolescents and young adults. Federal officials are urging legislation to educate physicians about the use and effects of potent narcotics, which are increasingly being prescribed for chronic pain. ASAM developed strategies in the 1980s to identify the small minority of misprescribers and focused educational and retraining efforts on these individuals. As health reform and more prevalent pain management put more primary care physicians in a gatekeeper role to manage the medical care of addicts, these clinicians must become aware of the abuse potential of the powerful narcotics they prescribe. Increased reference to state-maintained controlled medication databases can also reduce misprescribing. PMID:22641967

Smith, David E

209

Licit, Illicit, and Non-medical Prescription Drug Abuse Among Pharmacists  

Microsoft Academic Search

The use of licit, illicit, and non-medical prescription drug abuse among pharmacists is a growing problem in the U.S. Studies and surveys have shown that health care professionals, including pharmacists, are more likely than the general population to abuse drugs, particularly prescription drugs. As pharmacists, this poses an ethical problem for all of us. As a pharmacist, we are one

Anna McDonald

210

Medicare Part D Program: Prescription Drug Plan Copayment Structure and Premium Sensitivity  

Microsoft Academic Search

Since January 2006 Medicare beneficiaries have the option to purchase prescription drug benefits from Medicare under the Part D program. The addition of outpatient drugs to the Medicare programs reflects Congress’ recognition of the fundamental change in recent years in how medical care is delivered in the U.S. It recognizes the vital role of prescription drugs in the health care

Rui Dai

2009-01-01

211

Prescription Drug Coverage and Medicare Spending among U.S. Elderly&ast  

Microsoft Academic Search

The introduction of Medicare Part D has generated interest in the cost of providing drug coverage to the elderly. Of paramount importance—often unaccounted for in budget estimates—are the salutary effects that increased prescription drug use might have on other Medicare spending. This paper uses longitudinal data from the Medicare Current Beneficiary Survey to estimate how prescription drug benefits affect Medicare

Baoping Shang; Dana Goldman

2010-01-01

212

21 CFR 250.101 - Amphetamine and methamphetamine inhalers regarded as prescription drugs.  

Code of Federal Regulations, 2013 CFR

...Prescription Status of Specific Drugs § 250.101 Amphetamine...regarded as prescription drugs. (a) Recurring reports of abuse and misuse of methamphetamine...through over-the-counter sale. From complaints...well as from Food and Drug Administration...

2013-04-01

213

Nonmedical Prescription Drug Use among Adolescents: The Influence of Bonds to Family and School  

ERIC Educational Resources Information Center

There has been a tremendous increase in the prevalence of nonmedical prescription drug use among adolescents in recent years. Research now indicates that the prevalence of nonmedical prescription drug use is greater than the prevalence of other illicit drug use, excluding marijuana. Despite these recent trends, there is a dearth of research in the…

Ford, Jason A.

2009-01-01

214

Nonmedical Prescription Drug Use among Adolescents: The Influence of Bonds to Family and School  

ERIC Educational Resources Information Center

|There has been a tremendous increase in the prevalence of nonmedical prescription drug use among adolescents in recent years. Research now indicates that the prevalence of nonmedical prescription drug use is greater than the prevalence of other illicit drug use, excluding marijuana. Despite these recent trends, there is a dearth of research in…

Ford, Jason A.

2009-01-01

215

Mechanisms of Prescription Drug Diversion Among Drug-Involved Club- and Street-Based Populations  

PubMed Central

Objective Prescription drug diversion involves the unlawful channeling of regulated pharmaceuticals from legal sources to the illicit marketplace, and can occur along all points in the drug delivery process, from the original manufacturing site to the wholesale distributor, the physician's office, the retail pharmacy, or the patient. However, empirical data on diversion are limited. Method In an attempt to develop a better understanding of how specific drug-using populations are diverting prescription opioids and other medications, or obtaining controlled drugs that have already been diverted, qualitative interviews and focus group data were collected on four separate populations of prescription drug abusers in Miami, Florida—club drug users, street-based illicit drug users, methadone maintenance patients, and HIV positive individuals who abuse and/or divert drugs. Results Sources of abused prescription drugs cited by focus group participants were extremely diverse, including their physicians and pharmacists; parents and relatives; “doctor shopping”; leftover supplies following an illness or injury; personal visits to Mexico, South America and the Caribbean; prescriptions intended for the treatment of mental illness; direct sales on the street and in nightclubs; pharmacy and hospital theft; through friends or acquaintances; under-the-door apartment flyers advertising telephone numbers to call; and “stealing from grandma's medicine cabinet.” Conclusion While doctor shoppers, physicians and the Internet receive much of the attention regarding diversion, the data reported in this paper suggest that there are numerous active street markets involving patients, Medicaid recipients and pharmacies as well. In addition, there are other data which suggest that the contributions of residential burglaries, pharmacy robberies and thefts, and “sneak thefts” to the diversion problem may be understated.

Inciardi, James A.; Surratt, Hilary L.; Kurtz, Steven P.; Cicero, Theodore J.

2010-01-01

216

Prescription Drug Misuse among Dating Partners: Within-Couple Associations and Implications for Intimate Relationship Quality  

PubMed Central

This study examined the associations between dating partners' misuse of prescription medications and the implications of misuse for intimate relationship quality. A sample of 100 young adult dating pairs completed ratings of prescription drug use and misuse, alcohol use, and relationship quality. Results indicated positive associations between male and female dating partners' prescription drug misuse, which were more consistent for past-year rather than lifetime misuse. Dyadic associations obtained via actor-partner interdependence modeling further revealed that individuals' prescription drug misuse holds problematic implications for their own but not their partners' intimate relationship quality. Models accounted for individuals' alcohol-related risk and medically-appropriate prescription drug use, suggesting the independent contribution of prescription drug misuse to reports of relationship quality. The findings highlight the importance of considering young adults' substance behaviors in contexts of their intimate relationships.

Papp, Lauren M.

2010-01-01

217

Changing Effects of Direct-to-Consumer Broadcast Drug Advertising Information Sources on Prescription Drug Requests  

Microsoft Academic Search

This study tracks the changes of the effects of 4 information sources for direct-to-consumer drug advertising on patients' requests for prescription drugs from physicians since the inception of the “Guidance for Industry about Consumer-directed Broadcast Advertisements.” The Guidance advises pharmaceuticals to use four information sources for consumers to seek further information to supplement broadcast drug advertisements: small-print information, the Internet,

Annisa Lai Lee

2009-01-01

218

21 CFR 205.50 - Minimum requirements for the storage and handling of prescription drugs and for the establishment...  

Code of Federal Regulations, 2010 CFR

...identity of the prescription drug products and to ensure that there is no delivery of prescription drugs that have been damaged...regulations. (1) Wholesale drug distributors shall permit...inspect their premises and delivery vehicles, and to...

2009-04-01

219

21 CFR 205.50 - Minimum requirements for the storage and handling of prescription drugs and for the establishment...  

Code of Federal Regulations, 2010 CFR

...identity of the prescription drug products and to ensure that there is no delivery of prescription drugs that have been damaged...regulations. (1) Wholesale drug distributors shall permit...inspect their premises and delivery vehicles, and to...

2010-04-01

220

21 CFR 205.50 - Minimum requirements for the storage and handling of prescription drugs and for the establishment...  

Code of Federal Regulations, 2013 CFR

21 Food and Drugs 4 2013-04-01 2013-04-01 false ...requirements for the storage and handling of prescription drugs and for the establishment and maintenance of prescription drug distribution records. 205.50 Section...

2013-04-01

221

Paying for AIDS drugs: A reform model for prescription drugs  

Microsoft Academic Search

By all accounts the eleventh International Conference on AIDS held in July 1996 in Vancouver, British Columbia, was far more encouraging than the previous ten. Several clinical studies showed that protease inhibitors, when combined with existing drugs, reduced the prevalence of HIV to such a degree that some now believe that we are on the verge of being able to

Robert Guell

1997-01-01

222

An Exploration of Social Circles and Prescription Drug Abuse Through Twitter  

PubMed Central

Background Prescription drug abuse has become a major public health problem. Relationships and social context are important contributing factors. Social media provides online channels for people to build relationships that may influence attitudes and behaviors. Objective To determine whether people who show signs of prescription drug abuse connect online with others who reinforce this behavior, and to observe the conversation and engagement of these networks with regard to prescription drug abuse. Methods Twitter statuses mentioning prescription drugs were collected from November 2011 to November 2012. From this set, 25 Twitter users were selected who discussed topics indicative of prescription drug abuse. Social circles of 100 people were discovered around each of these Twitter users; the tweets of the Twitter users in these networks were collected and analyzed according to prescription drug abuse discussion and interaction with other users about the topic. Results From November 2011 to November 2012, 3,389,771 mentions of prescription drug terms were observed. For the 25 social circles (n=100 for each circle), on average 53.96% (SD 24.3) of the Twitter users used prescription drug terms at least once in their posts, and 37.76% (SD 20.8) mentioned another Twitter user by name in a post with a prescription drug term. Strong correlation was found between the kinds of drugs mentioned by the index user and his or her network (mean r=0.73), and between the amount of interaction about prescription drugs and a level of abusiveness shown by the network (r=0.85, P<.001). Conclusions Twitter users who discuss prescription drug abuse online are surrounded by others who also discuss it—potentially reinforcing a negative behavior and social norm.

2013-01-01

223

Motivations for Non-Medical Prescription Drug Use: A Mixed Methods Analysis  

PubMed Central

Despite a dramatic increase in the non-medical use of prescription drugs among illicit drug users, their motives for abusing prescription drugs are still largely unknown. The objective of this study was to 1) determine the motivations for engaging in the non-medical use of prescription opioids and sedatives among street-based illicit drug users, methadone maintenance patients, and residential drug treatment clients, 2) examine associations between prescription drug abuse motivations and gender, age, race/ethnicity, and user group, and 3) examine associations between specific motivations and prescription drug abuse patterns. Quantitative surveys (n = 684) and in-depth interviews (n = 45) were conducted with a diverse sample of prescription drug abusers in South Florida between March 2008 and November 2009. The three most common motivations reported were “to get high”, “to sleep”, and “for anxiety/stress”. There were age, race/ethnicity, and gender differences by motives. Prescription drug abuse patterns were also found to be associated with specific motivations. While additional research is needed, these findings serve to inform appropriate prevention and treatment initiatives for prescription drug abusers.

Rigg, Khary K.; Ibanez, Gladys E.

2010-01-01

224

Caffeine overdose  

MedlinePLUS

Caffeine is a substance that exists naturally in certain plants. It can also be produced synthetically and ... and a diuretic, which means it increases urination. Caffeine overdose occurs when someone accidentally or intentionally takes ...

225

Nitroglycerin overdose  

MedlinePLUS

Nitroglycerin is a medicine that helps relax the blood vessels leading to the heart. It is used to prevent and treat chest pain. Nitroglycerin overdose occurs when someone accidentally or intentionally takes ...

226

Definition of Rural in the Context of MMA (Medicare Prescription Drug, Improvement, and Modernization Action) Access Standards for Prescription Drug Plans.  

National Technical Information Service (NTIS)

When the full benefits of the Medicare Prescription Drug, Improvement, and Modernization Action of 2003 (MMA) become operational in 2006, medications will be more affordable for some Medicare beneficiaries in rural America. However, an important policy qu...

K. J. Mueller R. T. Slifkin M. D. Shambaugh-Miller R. K. Randolph

2004-01-01

227

Perception of Generic Prescription Drugs and Utilization of Generic Drug Discount Programs  

PubMed Central

Objective Our study aimed to assess patient’s perceptions of generic drugs and utilization of generic drug discount programs. Design, Setting and Participants A survey was administered to adult participants at community health centers and community-based organizations in Houston, Texas, USA (n=525). Main Outcome Measures Multivariate logistic regression was used to quantify the strength of association between generic drug perception and utilization of generic drug discount programs. Results Respondents who agreed that “Generic prescription drugs are as effective as brand name prescription drugs,” were 3 times as likely to utilize generic drug discount programs (AOR: 3.0, 95% CI: 1.8–4.8, P<.001). Compared to non-Hispanic Whites, African Americans (OR: 10.2; 95% CI: 1.4–76.4) and Hispanics (OR: 10.3; 95% CI: 1.3–79.4) were 10 times as likely to agree that generic drugs have more side effects than brand name drugs. Conclusion Race/ethnicity had no impact in utilization of generic drug discount programs, despite racial disparities in perception toward generic drugs’ side effects and generic drugs being inferior to brand name drugs.

Omojasola, Anthony; Hernandez, Mike; Sansgiry, Sujit; Jones, Lovell

2012-01-01

228

In 1995, FDA proposed a regulation entitled Prescription Drug ...  

Center for Biologics Evaluation and Research (CBER)

Text Version... consumers and make it difficult to determine the most ... How will you pay for the prescriptions? ... any over-the- counter or non-prescription medications ... More results from www.fda.gov/downloads/advisorycommittees/committeesmeetingmaterials

229

Use, Abuse and Dependence of Prescription Drugs in Adolescents and Young Adults  

Microsoft Academic Search

Lifetime prevalence estimates of psychotropic medicine use as well as prevalence of DSM-IV prescription drug use disorders from the baseline investigation of the Early Developmental Stages of Psychopathology (EDSP) Study are presented. Use of prescription medication at some time in their life was reported by 27.4% of the respondents. Illicit use of prescription drugs, which means an intake without medical

Roselind Lieb; Hildegard Pfister; Hans-Ulrich Wittchen

1998-01-01

230

Epidemiologic Trends in Drug Abuse Advance Report: Prescription Drug Abuse. Community Epidemiology Work Group, June 2004.  

National Technical Information Service (NTIS)

This Advance Report is based on findings related to the nonmedical use or abuse of prescription drugs that were presented at the 56th semiannual meeting of the Community Epidemiology Work Group (CEWG) in Arlington, Virginia, on June 811, 2004, under spons...

2004-01-01

231

An Exploratory Study of SocioCultural Factors Contributing to Prescription Drug Misuse among College Students  

Microsoft Academic Search

Although recent increases in collegiate prescription drug misuse have generated a great deal of concern, there are few analyses available that examine the socio-cultural factors influencing these trends. This article attempts to address this gap in knowledge by providing an analysis of several socio-cultural factors influencing pharmaceutical misuse by college students. Prescription drugs are put to a number of different

Gilbert Quintero; Jeffery Peterson; Bonnie Young

2006-01-01

232

Total and Out-of-Pocket Expenditures for Prescription Drugs among Older Persons  

ERIC Educational Resources Information Center

|Purpose: The burden of prescription drug costs on Medicare beneficiaries has become a critical policy issue in improving the Medicare program, yet few studies have provided detailed and current information on that burden. The present study estimates total and out-of-pocket expenditures for prescription drugs and the burden of these costs in…

Sambamoorthi, Usha; Shea, Dennis; Crystal, Stephen

2003-01-01

233

Prescription Drug Expenditures in the United States: The Effects of Obesity, Demographics, and New Pharmaceutical Products  

Microsoft Academic Search

During the period 1990–1998, real per capita expenditures on prescription drugs in the United States increased by 84% (1996 dollars, GDP deflator). This paper examines the factors driving prescription drug expenditures in the United States and provides some quantitative measures. Panel data from all 50 states for 1990–1998 are employed. In addition to an aging population, other important determinants of

Donald Vandegrift; Anusua Datta

2006-01-01

234

Total and Out-of-Pocket Expenditures for Prescription Drugs Among Older Persons  

Microsoft Academic Search

Purpose: The burden of prescription drug costs on Medicare beneficiaries has become a critical policy issue in improving the Medicare program, yet few studies have provided detailed and current infor- mation on that burden. The present study estimates total and out-of-pocket expenditures for prescription drugs and the burden of these costs in relation to in- come among the elderly population.

Usha Sambamoorthi; Dennis Shea; Stephen Crystal

2003-01-01

235

Adverse childhood experiences and prescription drug use in a cohort study of adult HMO patients  

Microsoft Academic Search

BACKGROUND: Prescription drugs account for approximately 11% of national health expenditures. Prior research on adverse childhood experiences (ACEs), which include common forms of child maltreatment and related traumatic stressors, has linked them to numerous health problems. However, data about the relationship of these experiences to prescription drug use are scarce. METHOD: We used the ACE Score (an integer count of

Robert F Anda; David W Brown; Vincent J Felitti; Shanta R Dube; Wayne H Giles

2008-01-01

236

An Exploration of the Relationship between the Use of Methamphetamine and Prescription Drugs  

ERIC Educational Resources Information Center

This study examines patterns of use of prescription drugs and methamphetamine. We drew our sample from a study about 130 active and inactive methamphetamine users and focused on 16 participants with a recent history of methamphetamine and prescription drug use. We collected in-depth interviews to explore relationships in use trajectory patterns.…

Lamonica, Aukje K.; Boeri, Miriam

2012-01-01

237

Are Direct to Consumer Advertisements of Prescription Drugs Educational?: Comparing 1992 to 2002  

ERIC Educational Resources Information Center

|We investigate the educational value of direct-to-consumer (DTC) prescription drug advertisements from 58 popular magazines published in 1992 and 2002. We find that the number of DTC prescription drug ads increased nine-fold from 1992 to 2002, while the advertisements for other health care products increased only slightly. We examine changes in…

Curry, Timothy Jon; Jarosch, Jeff; Pacholok, Shelley

2005-01-01

238

Nonmedical Prescription Drug Use among College Students: A Comparison between Athletes and Nonathletes  

ERIC Educational Resources Information Center

|Objective: Given the substantial increase in nonmedical prescription drug use in recent years and a lack of research on the topic, the author analyzed data on nonmedical prescription drug use among college students. Participants and Methods: Using data from the 2001 College Alcohol Study (N = 10,904), the author examined variation in nonmedical…

Ford, Jason A.

2008-01-01

239

Nonmedical Prescription Drug Use and Delinquency: An Analysis with a National Sample  

Microsoft Academic Search

There is an abundance of research on the association between substance use and delinquency. However, an area yet to be examined is the association between nonmedical prescription drug use and delinquency. This is important given the substantial increase in nonmedical prescription drug use in recent years and the fact that recent national surveys of substance use show that the prevalence

Jason A. Ford

2008-01-01

240

Prescription Drug Misuse among University Staff and Students: A Survey of Motives, Nature and Extent  

ERIC Educational Resources Information Center

|Aims: To determine the prevalence and nature of prescription drug misuse among university staff and students in the UK. Methods: In 2009, an online questionnaire regarding non-medical use of prescription drugs was completed by 1614 students and 489 staff registered at a large university in Wales. The sample data were weighted to match the…

Holloway, Katy; Bennett, Trevor

2012-01-01

241

Internal and External Factors Associated with Illicit Prescription Drug Use in College Students  

Microsoft Academic Search

With data suggesting emerging adulthood is a time of increased risk for illicit prescription drug use, it is essential that factors contributing to this be understood to guide prevention efforts. Internal factors (stress, GPA, gender) and external factors (type of institution, living situation) were assessed in tandem with perceptions of harm and illicit prescription drug use. In accordance with nationwide

Robyn A. Dolson; Eric Tompkins; Tanya L. Tompkins

2012-01-01

242

An Exploration of the Relationship between the Use of Methamphetamine and Prescription Drugs  

ERIC Educational Resources Information Center

|This study examines patterns of use of prescription drugs and methamphetamine. We drew our sample from a study about 130 active and inactive methamphetamine users and focused on 16 participants with a recent history of methamphetamine and prescription drug use. We collected in-depth interviews to explore relationships in use trajectory patterns.…

Lamonica, Aukje K.; Boeri, Miriam

2012-01-01

243

Are Direct to Consumer Advertisements of Prescription Drugs Educational?: Comparing 1992 to 2002  

ERIC Educational Resources Information Center

We investigate the educational value of direct-to-consumer (DTC) prescription drug advertisements from 58 popular magazines published in 1992 and 2002. We find that the number of DTC prescription drug ads increased nine-fold from 1992 to 2002, while the advertisements for other health care products increased only slightly. We examine changes in…

Curry, Timothy Jon; Jarosch, Jeff; Pacholok, Shelley

2005-01-01

244

Misperceptions of Nonmedical Prescription Drug Use: A Web Survey of College Students  

PubMed Central

Objectives This study compared undergraduate students’ perceived versus actual prevalence rates of nonmedical use of marijuana, prescription opioids and prescription stimulants. Methods In 2005, a randomly selected sample of 3,639 college students self-administered a Web survey regarding their substance use behaviors and attitudes (68% response rate). Results The majority of undergraduate students overestimated the prevalence of nonmedical use of prescription stimulants (70.2%) and prescription opioids (69.9%) and marijuana use (50.5%) among peers on their campus. The mean difference between perceived versus actual past year use was considerably greater for nonmedical use of prescription stimulants (mean difference = 12.2, 95% CI = 11.7 – 12.7) and prescription opioids (mean difference = 8.8, 95% CI = 8.3 – 9.2) than marijuana (mean difference = 2.9, 95% CI = 2.2 – 3.6). Multivariate regression analysis revealed overestimation of nonmedical use of prescription drugs was significantly associated with gender and medical use of prescription drugs. Conclusions The findings provided strong evidence of misperception of nonmedical prescription drug use among college students. Future research and prevention efforts should assess the impact of correcting misperceived norms on reducing nonmedical prescription drug use.

McCabe, Sean Esteban

2008-01-01

245

CBO Study: Issues in Designing a Prescription Drug Benefit for Medicare.  

National Technical Information Service (NTIS)

One of lawmakers' highest health-related priorities is adding a prescription drug benefit to Medicare. Although that program gives older Americans broad insurance coverage for many health needs, it provides only limited coverage of drugs not dispensed dur...

2002-01-01

246

76 FR 58020 - Prescription Drug User Fee Act IV Information Technology Plan  

Federal Register 2010, 2011, 2012, 2013

...Prescription Drug User Fee Act IV Information Technology Plan AGENCY: Food and Drug Administration...the availability of an updated information technology (IT) plan entitled ``PDUFA IV Information Technology Plan'' (updated plan) to...

2011-09-19

247

Barely or fairly balancing drug risks? Content and format effects in direct-to-consumer online prescription drug promotions  

Microsoft Academic Search

A critical requirement of direct-to-consumer (DTC) drug promotion on the Internet is the concept of fair balance. This means that prescription drug Web sites should provide an accurate, balanced portrayal of the risks relative to the benefits of using prescription medications. However, one of the most pervasive findings in con- sumer research is that risk perceptions are often not aligned

Jeremy Kees; Paula Fitzgerald Bone; John Kozup; Pam Scholder Ellen

2008-01-01

248

75 FR 61621 - Charges Billed to Third Parties for Prescription Drugs Furnished by VA to a Veteran for a...  

Federal Register 2010, 2011, 2012, 2013

...RIN 2900-AN15 Charges Billed to Third Parties for Prescription Drugs Furnished...of prescription drugs) from a third party to the extent that the veteran...eligible to receive payment from the third party for: A...

2010-10-06

249

Using National Drug Codes and Drug Knowledge Bases to Organize Prescription Records from Multiple Sources  

PubMed Central

Purpose Pharmacy systems contain electronic prescription information needed for clinical care, decision support, performance measurements and research. The master files of most pharmacy systems include National Drug Codes (NDCs) as well as the local codes they use within their systems to identify the products they dispense. We sought to assess how well one could map the products dispensed by many pharmacies to clinically oriented codes via the mapping tables provided by Drug Knowledge Base (DKB) producers. Methods We obtained a large sample of prescription records from seven different sources. These records either carried a national product code or a local code that could be translated into a national product code via their formulary master. We obtained mapping tables from five DKBs. We measured the degree to which the DKB mapping tables covered the national product codes carried in, or associated with, our sample of prescription records. Results Considering the total prescription volume, DKBs covered 93.0% to 99.8% of the product codes (15 comparisons) from three outpatient, and 77.4% to 97.0% (20 comparisons) from four inpatient, sources. Among the inpatient sources, invented codes explained much – from 36% to 94% (3 of 4 sources) – of the non coverage. Outpatient pharmacy sources invented codes rarely – in 0.11% to 0.21% of their total prescription volume, and inpatient sources, more commonly – in 1.7% to 7.4% of their prescription volume. The distribution of prescribed products is highly skewed: from 1.4% to 4.4% of codes account for 50% of the message volume; from 10.7% to 34.5% of codes account for 90% of the volume. Conclusion DKBs cover the product codes used by outpatient sources sufficiently well to permit automatic mapping. Changes in policies and standards could increase coverage of product codes used by inpatient sources.

Simonaitis, Linas; McDonald, Clement J

2009-01-01

250

A study of the risk of mental retardation among children of pregnant women who have attempted suicide by means of a drug overdose  

PubMed Central

Abstract: Background: The aim of the study was to estimate the effect on the fetal development of high doses of prescription drugs taken as a suicide attempt during pregnancy. Methods: Pregnant women were identified among self-poisoned females in the toxicological inpatient clinic in Budapest between 1960 and 1993. Congenital abnormalities, intrauterine development based on birth weight and post-conceptional age, mental retardation, cognitive-behavioral status were compared in exposed children born to mothers who had attempted suicide by means of a drug overdose during pregnancy with their siblings, born either before or after the affected pregnancy, as sib controls. Results: Of a total of 1 044 pregnant women, 74 used the combination of amobarbital, glutethimide and promethazine (Tardyl®, one of the most popular drugs for treatment of insomnia in Hungary) for suicide attempt. Of these 74 women, 27 delivered live-born babies. The mean dose of Tardyl® used for suicide attempts was 24 times the usually prescribed clinical dose. The rate of congenital abnormalities and intrauterine retardation was not higher in exposed children than in their sib controls. However, of the 27 exposed children, eight (29.6%) were mentally retarded (?\\documentclass[12pt]{minimal} \\usepackage{wasysym} \\usepackage[substack]{amsmath} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage[mathscr]{eucal} \\usepackage{mathrsfs} \\DeclareFontFamily{T1}{linotext}{} \\DeclareFontShape{T1}{linotext}{m}{n} { <-> linotext }{} \\DeclareSymbolFont{linotext}{T1}{linotext}{m}{n} \\DeclareSymbolFontAlphabet{\\mathLINOTEXT}{linotext} \\begin{document} $$ {\\mathrm{_{{1}}^{{2}}}} $$ \\end{document} )=79.7, p= Sig) while mental retardation did not occur among 46 sib controls. These exposed children were born to mothers who attempted suicide with Tardyl® between the 14th and 20th post-conceptional weeks. The components of Tardyl® used separately for a suicide attempt during pregnancy were not associated with a higher risk of mental retardation. Therefore the high doses of Tardyl® associated with the high risk for mental retardation may be due to the interaction of its three drug components. Conclusions: The findings of the study showed that the high doses of a drug containing three components may be associated with a significantly increased risk for mental retardation without any structural defects, whereas each of these three component drugs taken alone was not associated with this adverse effect.

Petik, Dora; Czeizel, Barbara; Banhidy, Ferenc; Czeizel, Andrew E.

2012-01-01

251

Identification of designer drug 2C-E (4-ethyl-2, 5-dimethoxy-phenethylamine) in urine following a drug overdose  

PubMed Central

In recent years, access to information regarding acquisition and synthesis of newer designer drugs has been at an all-time high due largely to the Internet. As these drugs have become more prevalent, laboratory techniques have been developed and refined to identify and screen for this burgeoning population of drugs. This provides a unique opportunity for learning about many of these methods. Laboratory testing techniques and instrumentation are obscure to many health care professionals, yet their results are crucial. Here, we present a case of an overdose of an uncommon designer drug (2C-E) and discuss the basics of liquid chromatography and mass spectrometry, two important techniques used in isolating and identifying the drug. Although often overlooked and taken for granted, these techniques can play a pivotal role in the diagnosis and subsequent management of select patients.

Van Vrancken, Michael J.; Benavides, Raul; Wians, Frank H.

2013-01-01

252

Injectable paracetamol in children: yet more cases of 10-fold overdose.  

PubMed

Intravenous paracetamol injection is associated with a risk of 10-fold overdose. This is due to confusion between normal dose prescription in milligrams and administration in millilitres of injectable solution (containing 10 mg per ml). Reports of overdose show that the consequences can be severe, due to the hepatic toxicity of paracetamol, which may be fatal if the error is not detected rapidly enough for antidote (acetylcysteine) administration. In practice, injectable paracetamol should only be prescribed when oral administration is not possible. Care must be taken when calculating the dose to be administered, and the calculation must be double checked before the drug is administered. PMID:23444503

2013-02-01

253

Gender and other factors associated with the nonmedical use of abusable prescription drugs.  

PubMed

Although there is extensive research on gender differences in the use of alcohol and illicit substances, few studies have examined gender differences in nonmedical prescription drug use, Using data from the 1991 National Household Survey on Drug Abuse (NHSDA), based on a sample of 3185 persons, logistic regression analysis is employed to determine how gender and other factors affect the likelihood of past-year nonmedical prescription drug use. Analysis revealed that women are significantly more likely than men to use any prescription drug, and that this gender difference is primarily driven by women's increased risk for narcotic analgesic and minor tranquilizer nonmedical use. Other factors, such as race, age, health status, and other substance use, also are significant predictors of nonmedical use. Findings from this study will enable researchers, policy makers, and providers to have a greater understanding of nonmedical drug use patterns and support greater gender sensitivity in the prevention, education, and treatment of nonmedical prescription drug use. PMID:15002942

Simoni-Wastila, Linda; Ritter, Grant; Strickler, Gail

2004-01-01

254

Drug prescription in pregnancy: analysis of a large statutory sickness fund population  

Microsoft Academic Search

ObjectiveTo examine the prescription of drugs in Germany prior to, during and after pregnancy.MethodsFor the first time, prescription data of a large cohort of pregnant women, from a German statutory sickness fund, were available for scientific analysis. For each woman who gave birth between June 2000 and May 2001 reimbursed prescriptions for two periods (90 days each) before pregnancy, three

Veronika Egen-Lappe; Joerg Hasford

2004-01-01

255

Riskier Than We Think? The Relationship Between Risk Statement Completeness and Perceptions of Direct to Consumer Advertised Prescription Drugs  

Microsoft Academic Search

Direct to consumer (DTC) prescription drug advertising is one of the fastest growing categories of advertising. Expenditures have increased from about $25 million in 1992 to nearly $2 billion in 1999. Given strong evidence of consumer driven demand for advertised prescription drugs, research was conducted to assess the extent to which DTC prescription drug advertising provides consumers with the information

Joel J. Davis

2000-01-01

256

Prescription and over-the-counter drug treatment admissions to the California public treatment system.  

PubMed

Prescription and over-the-counter (OTC) drug abuse has become a focal point of public health policy, prevention, and control efforts. Adolescents represent one of the fastest growing segments of the general population abusing prescription and OTC drugs as represented by national surveys. This article reports on treatment admission data to the California addiction public system for prescription and OTC drugs among two age subgroups: adolescents 12-17 years and adults 18 years and older. Of the 6,841 admissions for primary abuse of prescription and OTC drugs in California (during 2006-2007), most adolescent admissions (12-17) were for stimulant prescription and OTC drugs (45.3% and 32.1%, respectively), whereas opioid prescription drugs (88.9%) were most common for adults 18 years and older. Differences in psychosocial, treatment, and substance use characteristics between these two age subgroups are described. Results from this study offer useful treatment admission information about prescription and OTC drug abuse within the California public addiction treatment system. PMID:21193282

Gonzales, Rachel; Brecht, Mary-Lynn; Mooney, Larissa; Rawson, Richard A

2010-12-28

257

Patterns of prescription drug use and incidence of drug-drug interactions in patients reporting to medical emergency.  

PubMed

Pharmaco-epidemiological studies detailing prescribing patterns of physicians are very few from developing countries. The present study describes the patterns of prescription of drugs by physicians working in different clinical settings in India and explores using the prescriptions the incidence of potential drug-drug interactions (DDI). This study was a cross-sectional observational study. The prescriptions of patients for any chronic medical condition and drug therapy received at the first point of contact with health care services for present medical emergency were analyzed for information. The prescriptions were also analyzed for potential DDI. Data were expressed as mean ± SD or median and inter-quartile range. Multiple logistic regression was used for variables likely to be associated with incidence of DDI. Of total 710 patients, 565 prescriptions were available for analysis. Of the chronic diseases, hypertension (17.7%) and diabetes mellitus (16.8%) were the commonest. Alcoholic liver disease had maximum average number of drugs prescribed (3.9). Supplements were the most commonly prescribed pharmacological agents for chronic disease (142/796). Patients in 35-50 years of age consumed maximum average number of drugs (1.9). Antibiotics were the most frequently prescribed agents (148/1240) followed by supplements (122/1240). We noted 296 mild and moderate potential DDI. Literacy of patients and polypharmacy were the factors associated significantly with DDI. Patients in India do not consume large number of allopathic medicines. The practice of prescribing supplements and antibiotics needs to be reviewed. Potential DDI are not an important problem. Prescription policies need significant revision. PMID:21895763

Dhamija, Puneet; Bansal, Dipika; Srinivasan, Anand; Bhalla, Ashish; Hota, Debasish; Chakrabarti, Amitava

2011-09-05

258

Physicians' Knowledge of and Willingness to Prescribe Naloxone to Reverse Accidental Opiate Overdose: Challenges and Opportunities  

PubMed Central

Naloxone, the standard treatment for heroin overdose, is a safe and effective prescription drug commonly administered by emergency room physicians or first responders acting under standing orders of physicians. High rates of overdose deaths and widely accepted evidence that witnesses of heroin overdose are often unwilling or unable to call 9-1-1 has led to interventions in several US cities and abroad in which drug users are instructed in overdose rescue techniques and provided a “take-home” dose of naloxone. Under current Food and Drug Administration (FDA) regulations, such interventions require physician involvement. As part of a larger study to evaluate the knowledge and attitudes of doctors towards providing drug treatment and harm reduction services to injection drug users (IDUs), we investigated physician knowledge and willingness to prescribe naloxone. Less than one in four of the respondents in our sample reported having heard of naloxone prescription as an intervention to prevent opiate overdose, and the majority reported that they would never consider prescribing the agent and explaining its application to a patient. Factors predicting a favorable attitude towards prescribing naloxone included fewer negative perceptions of IDUs, assigning less importance to peer and community pressure not to treat IDUs, and increased confidence in ability to provide meaningful treatment to IDUs. Our data suggest that steps to promote naloxone distribution programs should include physician education about evidence-based harm minimization schemes, broader support for such initiatives by professional organizations, and policy reform to alleviate medicolegal concerns associated with naloxone prescription. FDA re-classification of naloxone for over-the-counter sales and promotion of nasal-delivery mechanism for this agent should be explored.

Ruthazer, Robin; Macalino, Grace E.; Rich, Josiah D.; Tan, Litjen; Burris, Scott

2006-01-01

259

NATIONAL SURVEY OF PRESCRIPTION DRUG INFORMATION PROVIDED TO PATIENTS (NSPDIPP)  

EPA Science Inventory

National telephone surveys were conducted in 1992, 1994, 1996, and 1998 to determine how much prescription medicine information consumers receive and through which sources. Approximately 1,000 U.S. consumers who received a new prescription for themselves or a family member at a r...

260

Unusual abdominal complications of a suicidal overdose of analgesic and psychotropic drugs in an elderly patient.  

PubMed

A suicidal 67-year-old woman with manic-depressive psychosis took an overdose of asprin, amitriptyline and diazepam. The initial effects were pyrexia, tachycardia, hyperpnea, metabolic acidosis, electrocardiographic changes, hypoprothrombinemia, gastritis, and pancreatitis. Four to six weeks later, she was examined because of persistent abdominal pain with mausea, anorexia anemia, and possibly a malabsorption syndrome. An exploratory laparotomy was performed. The surgeon found several previous adhesions, a small intestinal volvulus, and a nodular pancreas. This suggested previous perforation of the small bowel from enteritis, causing a "blind-loop" syndrone. The invilved section of the small bowel was resected. With appropriate treatment, the patient is well three months after operation. PMID:618954

Mehta, D; Mehta, S; Mathew, P

1978-01-01

261

Pyrilamine-induced prolonged QT interval in adolescent with drug overdose.  

PubMed

The widespread availability of antihistamines in many over-the-counter preparations can lead to significant hazard to the public because of their possible link to potential ventricular arrhythmias secondary to prolongation of QT interval. The effect can be further compounded by the use of other commonly used medications such as macrolides, antifungal agents, antipsychotics, and other antihistamine-containing preparations. The effect of antihistamines on QT interval is not a class effect but is unique to certain medications. Pyrilamine, a first-generation antihistaminic agent, is considered safe as there are no reports regarding its cardiac toxicity available in literature. We report a case of an adolescent with prolonged QT interval after an overdose of pyrilamine. PMID:21975494

Paudel, Govinda; Syed, Muhammad; Kalantre, Sarika; Sharma, Jayendra

2011-10-01

262

Medicare program; e-prescribing and the prescription drug program. Final rule.  

PubMed

This final rule adopts standards for an electronic prescription drug program under Title I of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). These standards will be the foundation standards or the first set of final uniform standards for an electronic prescription drug program under the MMA, and represent the first step in our incremental approach to adopting final foundation standards that are consistent with the MMA objectives of patient safety, quality of care, and efficiencies and cost savings in the delivery of care. PMID:16273748

2005-11-01

263

Income and the Use of Prescription Drugs by the Elderly: Evidence from the Notch Cohorts  

ERIC Educational Resources Information Center

We use exogenous variation in Social Security payments created by the Social Security benefits notch to estimate how retirees' use of prescription medications responds to changes in their incomes. Using data from the 1993 Wave of the AHEAD, we obtain instrumental variables estimates of the income elasticity of prescription drug use that are…

Moran, John R.; Simon, Kosali Ilayperuma

2006-01-01

264

Quantifying Age-Related Differences in Information Processing Behaviors When Viewing Prescription Drug Labels  

Microsoft Academic Search

Adverse drug events (ADEs) are a significant problem in health care. While effective warnings have the potential to reduce the prevalence of ADEs, little is known about how patients access and use prescription labeling. We investigated the effectiveness of prescription warning labels (PWLs, small, colorful stickers applied at the pharmacy) in conveying warning information to two groups of patients (young

Raghav Prashant Sundar; Mark W. Becker; Nora M. Bello; Laura Bix

2012-01-01

265

Income and the Use of Prescription Drugs by the Elderly: Evidence from the Notch Cohorts  

ERIC Educational Resources Information Center

|We use exogenous variation in Social Security payments created by the Social Security benefits notch to estimate how retirees' use of prescription medications responds to changes in their incomes. Using data from the 1993 Wave of the AHEAD, we obtain instrumental variables estimates of the income elasticity of prescription drug use that are…

Moran, John R.; Simon, Kosali Ilayperuma

2006-01-01

266

Media Credibility and Informativeness of Direct-to-Consumer Prescription Drug Advertising  

Microsoft Academic Search

In this article, we report the results of a study conducted to determine consumer perceptions of the media credibility and informativeness of direct-to-consumer prescription drug advertising (DTC advertising) and to examine how those perceptions are influenced by consumer predispositions and demographic characteristics, especially consumer age. This study specifically surveyed older consumers, who are the most significant market segment for prescription

Jisu Huh; Denise E. Delorme; Leonard N. Reid

2004-01-01

267

Medical and Nonmedical Use of Prescription Drugs among Secondary School Students  

Microsoft Academic Search

PurposeThe main objective of this study was to assess the prevalence of medical and nonmedical use of four categories of prescription drugs (opioid, stimulant, sleeping, and sedative\\/anxiety medication) in a racially diverse sample of secondary public school students in the Detroit metropolitan area. A secondary objective was to examine the association between the use of four categories of prescription medications

Sean Esteban McCabe; Carol J. Boyd; Amy Young

2007-01-01

268

The relationship between source of diversion and prescription drug misuse, abuse, and dependence.  

PubMed

The current research examines the relationship between how people obtain prescription drugs (source of diversion) and how people misuse prescription drugs (i.e., frequency, abuse, and dependence). We analyzed data from the 2008 National Survey on Drug Use and Health public use file, a sample of 68,736 persons aged 12 and older that is generalizable to the noninstitutionalized population of the United States. A number of regression models were estimated, and findings indicate that source of diversion was significantly correlated to frequency of prescription drug misuse, abuse, and dependence. Given these findings, we believe any attempt to classify prescription drug misusers based on certain characteristics should include source of diversion. PMID:21174499

Ford, Jason A; Lacerenza, Christina

2010-12-21

269

Prevalence and correlates of prescription drug misuse among young, low-income women receiving public healthcare  

PubMed Central

The purpose of this study was to examine the prevalence and correlates of prescription drug misuse among young, low-income women seeking care at a public clinic in Texas. Collected data on 2976 women included frequency of use, demographic and reproductive characteristics, religiosity, smoking history, concurrent substance use, depressive symptoms, perceived stress, health beliefs, and exposure to traumatic events. Overall, 30% reported ever misusing a prescription drug; 15% reported misuse in the past year. Women who initiated sexual intercourse at <15 yo, used illicit drugs, and smoked everyday were more likely to have misused prescription drugs. Higher trauma, stress, and posttraumatic stress scores also were associated with ever misusing prescription drugs. This study adds to limited data available on medication misuse by young women with few resources and demonstrates needs for prevention efforts in public clinics.

Berenson, Abbey B.; Rahman, Mahbubur

2011-01-01

270

21 CFR 300.50 - Fixed-combination prescription drugs for humans.  

Code of Federal Regulations, 2010 CFR

...form prescription drugs for humans is as...a) Two or more drugs may be combined...requiring such concurrent therapy as defined in the labeling for the drug. Special cases of...of Food and Drugs based on his evaluation...or if substantial evidence of...

2010-04-01

271

21 CFR 300.50 - Fixed-combination prescription drugs for humans.  

Code of Federal Regulations, 2010 CFR

...form prescription drugs for humans is as...a) Two or more drugs may be combined...requiring such concurrent therapy as defined in the labeling for the drug. Special cases of...of Food and Drugs based on his evaluation...or if substantial evidence of...

2009-04-01

272

An explanatory model for state Medicaid per capita prescription drug expenditures.  

PubMed

Rising prescription drug expenditure is a growing concern for publicly funded drug benefit programs like Medicaid. To be able to contain drug expenditures in Medicaid, it is important that cause(s) for such increases are identified. This study attempts to establish an explanatory model for Medicaid prescription drugs expenditure based on the impacts of key influencers/predictors identified using a comprehensive framework of drug utilization. A modified Andersen's behavior model of health services utilization is employed to identify potential determinants of pharmaceutical expenditures in state Medicaid programs. Level of federal matching funds, access to primary care, severity of diseases, unemployment, and education levels were found to be key influencers of Medicaid prescription drug expenditure. Increases in all, except education levels, were found to result in increases in drug expenditures. Findings from this study could better inform intervention policies and cost-containment strategies for state Medicaid drug benefit programs. PMID:22963157

Roy, Sanjoy; Madhavan, S Suresh

2012-10-01

273

An analysis of N-acetylcysteine treatment for acetaminophen overdose using a systems model of drug-induced liver injury.  

PubMed

N-acetylcysteine (NAC) is the treatment of choice for acetaminophen poisoning; standard 72-h oral or 21-h intravenous protocols are most frequently used. There is controversy regarding which protocol is optimal and whether the full treatment course is always necessary. It would be challenging to address these questions in a clinical trial. We used DILIsym, a mechanistic simulation of drug-induced liver injury, to investigate optimal NAC treatment after a single acetaminophen overdose for an average patient and a sample population (n = 957). For patients presenting within 24 h of ingestion, we found that the oral NAC protocol preserves more hepatocytes than the 21-h intravenous protocol. In various modeled scenarios, we found that the 21-h NAC infusion is often too short, whereas the full 72-h oral course is often unnecessary. We found that there is generally a good correlation between the time taken to reach peak serum alanine aminotransferase (ALT) and the time taken to clear N-acetyl-p-benzoquinone imine (NAPQI) from the liver. We also found that the most frequently used treatment nomograms underestimate the risk for patients presenting within 8 h of overdose ingestion. V(max) for acetaminophen bioactivation to NAPQI was the most important variable in the model in determining interpatient differences in susceptibility. In conclusion, DILIsym predicts that the oral NAC treatment protocol, or an intravenous protocol with identical dosing, is superior to the 21-h intravenous protocol and ALT is the optimal available biomarker for discontinuation of the therapy. The modeling also suggests that modification of the current treatment nomograms should be considered. PMID:22593093

Woodhead, Jeffrey L; Howell, Brett A; Yang, Yuching; Harrill, Alison H; Clewell, Harvey J; Andersen, Melvin E; Siler, Scott Q; Watkins, Paul B

2012-05-16

274

State Variation in AIDS Drug Assistance Program Prescription Drug Coverage for Modifiable Cardiovascular Risk Factors  

Microsoft Academic Search

BACKGROUND  In the United States, mortality from cardiovascular disease has become increasingly common among HIV-infected persons. One-third\\u000a of HIV-infected persons in care may rely on state-run AIDS Drug Assistance Programs (ADAPs) for cardiovascular disease-related\\u000a prescription drugs. There is no federal mandate regarding ADAP coverage for non-HIV medications.\\u000a \\u000a \\u000a \\u000a \\u000a OBJECTIVE  To assess the consistency of ADAP coverage for type 2 diabetes, hypertension, hyperlipidemia, and

Oni J. Blackstock; Karen H. Wang; David A. Fiellin

275

The Effect of Reinsurance on Tier Placement for High-Cost Drugs in the Medicare Prescription Drug Benefit Program  

Microsoft Academic Search

An increasing fraction of new prescription drugs are expensive specialty drugs, with annual treatment costs of $40,000 or more. Designing appropriate insurance coverage for such drugs is an important policy question. Previous studies of optimal insurance coverage focus on trade-offs between appropriate incentives and financial protection for patients. In the case of these drugs, protecting the insurer against undue financial

Erin Taylor; Patricia Danzon

2010-01-01

276

77 FR 16973 - Direct-to-Consumer Prescription Drug Advertisements; Presentation of the Major Statement in...  

Federal Register 2010, 2011, 2012, 2013

...Presentation of the Major Statement in Television and Radio Advertisements in a Clear...statement in direct-to- consumer (DTC) television and radio advertisements relating to...Direct-to-Consumer Prescription Drug Television Advertisements'' (Distraction...

2012-03-23

277

77 FR 4273 - Direct-to-Consumer Prescription Drug Advertisements; Presentation of the Major Statement in...  

Federal Register 2010, 2011, 2012, 2013

...Presentation of the Major Statement in Television and Radio Advertisements in a Clear...statement in direct-to-consumer (DTC) television and radio advertisements relating to...Direct-to- Consumer Prescription Drug Television Advertisements'' (Distraction...

2012-01-27

278

Prescription drug samples--does this marketing strategy counteract policies for quality use of medicines?  

PubMed

Prescription drug samples, as used by the pharmaceutical industry to market their products, are of current interest because of their influence on prescribing, and their potential impact on consumer safety. Very little research has been conducted into the use and misuse of prescription drug samples, and the influence of samples on health policies designed to improve the rational use of medicines. This is a topical issue in the prescription drug debate, with increasing costs and increasing concerns about optimizing use of medicines. This manuscript critically evaluates the research that has been conducted to date about prescription drug samples, discusses the issues raised in the context of traditional marketing theory, and suggests possible alternatives for the future. PMID:12911677

Groves, K E M; Sketris, I; Tett, S E

2003-08-01

279

76 FR 79194 - Agency Information Collection Activities; Proposed Collection; Comment Request; Prescription Drug...  

Federal Register 2010, 2011, 2012, 2013

...Prescription Drug Product Labeling: Medication Guide Requirements AGENCY: Food and...distribution of patient labeling, called Medications Guides, for certain products that pose...distribution of FDA-approved patient medication. DATES: Submit either electronic...

2011-12-21

280

Patient Information and Prescription Drugs: Parallel Surveys of Physicians and Pharmacists.  

National Technical Information Service (NTIS)

Telephone surveys of 501 physicians and 500 pharmacists were undertaken to solicit health views and reported practices in regard to patient counseling and education about prescription drugs. The majority of physicians (88%) believed that their patients we...

J. M. Boyle

1983-01-01

281

Detailed Description of CBO's Cost Estimate for the Medicare Prescription Drug Benefit.  

National Technical Information Service (NTIS)

The recently enacted Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) contains many provisions that affect the Medicare program specifically and the U.S. health sector more generally. This paper focuses on the provisions that e...

2004-01-01

282

Staff Report on Sales, Promotion, and Product Differentiation in Two Prescription Drug Markets.  

National Technical Information Service (NTIS)

The report presents new evidence on the concept of product differentiation and its relationship to brand promotion and sales. Focusing upon two therapeutic markets for prescription drugs, the analysis supports in part, and refutes in part, the notion that...

D. F. Lean R. S. Bond

1977-01-01

283

Nonmedical use of prescription drugs among a longitudinal sample of dependent and problem drinkers  

Microsoft Academic Search

BackgroundIncreasing trends in the nonmedical use of prescription drugs (NMPD) have been documented, yet little is known about the demographic, severity, and social network influences related to NMPD among treated and untreated problem and dependent drinkers.

Helen Matzger; Constance Weisner

2007-01-01

284

Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Drug Expenses  

MedlinePLUS

... System Measurement Project Search string Home Topical Areas Measures Data Sources Help About Hello, Unknown User Administration ... High Out-of-Pocket Prescription Drug Expenses This measure reports the percentage of Medicare beneficiaries with high ...

285

How Teens Abuse Medicine: Prescription and Over-the-Counter Medications Account for Most of the Commonly Abused Drugs: Past Year Use Among High School Seniors.  

National Technical Information Service (NTIS)

Prescription drugs, a category of psychotherapeutics that comprises prescription-type pain relievers, tranquilizers, stimulants, and sedatives, are among the substances most commonly abused by young people in the United States. Prescription drugs are read...

2012-01-01

286

An Examination of Consumer Perceptions of Direct to Consumer Prescription Drug Advertisements And Implications for Current Food and Drug Administration Oversight of Direct to Consumer Advertisement Regulations  

Microsoft Academic Search

The debate over the effects of marketing prescription drugs to consumers is a rich and complex one. Proponents of direct to consumer (DTC) advertising of prescription drugs claim that advertisements provide consumers with powerful information about their health that they otherwise would not have had. Opponents claim that prescription drug advertisements market more expensive medications, leading consumers to request advertised

Nicole Nixen

287

Impact of Multitiered Copayments on the Use and Cost of Prescription Drugs among Medicare Beneficiaries  

PubMed Central

Objectives To assess the impact of multitiered copayments on the cost and use of prescription drugs among Medicare beneficiaries. Data Sources Marketscan 2002 Medicare Supplemental and Coordination of Benefits database and Plan Benefit Design database. Study Design The study uses cross-sectional variation in copayment structures among firms with a self-insured retiree health plan to measure the impact of number of copayment tiers on total and enrollee drug payments, number of prescriptions filled, and generic substitution. The study also assesses the effect of enrollee cost sharing on the cost and use of prescription medications for the long-term treatment of chronic conditions. Data Collection Methods We linked plan enrollment and benefit data with medical and drug claims for 352,760 Medicare beneficiaries with employer-sponsored retiree drug coverage. Primary Findings Medicare beneficiaries in three-tiered plans had 14.3 percent lower total drug expenditures, 14.6 percent fewer prescriptions filled, and 57.6 percent higher out-of-pocket costs than individuals in lower tiered plans. They also had fewer brand name and generic prescriptions filled, and a higher percentage of generics. The estimated price elasticity of demand for prescription drug expenditures was ?0.23. Finally, for maintenance medications used for the long-term treatment of chronic conditions, members in three-tiered plans had 11.5 percent fewer prescriptions filled. Conclusions Higher tiered drug plans reduce overall expenditures and the number of prescriptions purchased by Medicare beneficiaries. Beneficiaries are less responsive to cost sharing incentives when using drugs to treat chronic conditions.

Gilman, Boyd H; Kautter, John

2008-01-01

288

Media and Message Effects on DTC Prescription Drug Print Advertising Awareness  

Microsoft Academic Search

Despite various surveys of consumer attitudes toward direct-to-consumer (DTC) prescription drug advertising, little is known about the effectiveness of specific advertising campaigns. This article combines brand-level advertising awareness, media spending, and print advertising message strategy data to examine message effects on DTC prescription drug advertising awareness. The findings show that after controlling for media spending, several message strategies are associated

MARTIN S. ROTH

2003-01-01

289

Pricing of prescription drugs and its impact on physicians’ choice behavior  

Microsoft Academic Search

This research presents an analysis of Taiwan’s health care market with the focus on the pricing of prescription drugs and\\u000a its impact on physicians’ choice behavior. Since the advent of Taiwan’s national health insurance, with the competent authority\\u000a being Bureau of National Health Insurance (BNHI), hospitals are allowed to sell prescription drugs to patients at prices above\\u000a the purchasing prices,

Chen Miao-Sheng; Shih Yu-Ti

2008-01-01

290

Prescription drugs during pregnancy and lactation--a Finnish register-based study  

Microsoft Academic Search

Objective. To examine the use of prescription drugs in Finnish women before and during pregnancy and lactation.Methods. A register-based study linking four nation-wide registers in Finland: the Maternal Grants Register, the Drug Prescription Register, and the Special Refund Register (all maintained by the Social Insurance Institution in Finland; KELA), and the Finnish Population Register. The study included all women applying

Heli Malm; Jaana Martikainen; Timo Klaukka; Pertti J. Neuvonen

2003-01-01

291

What Does the Community Say: Key Informant Perceptions of Rural Prescription Drug Use  

Microsoft Academic Search

This article presents data from four groups of rural Key Informants—Community leaders, educators, health care providers and justice\\/law enforcement officials—to understand the nonmedical use and misuse of prescription drugs. Seventy key informants were purposively selected from two counties in Appalachian Kentucky. Key informants indicated that the nonmedical use of prescription drugs is complex and has historical roots. Two pathways, or

Carl Leukefeld; Robert Walker; Jennifer Havens; Cynthia A. Leedham; Valarie Tolbert

2007-01-01

292

Tramadol overdose: review of the literature  

Microsoft Academic Search

\\u000a Abstract  In France, like in several other European countries, dextroproxyphene has been banned from the market in 2011. Consequently,\\u000a a significant increase in tramadol prescriptions as well as a significant increase in tramadol overdoses and poisonings could\\u000a be expected. Tramadol is a synthetic opioid responsible for numerous adverse effects in case of overdose, including life-threatening\\u000a ones such as loss of consciousness,

R. Afshari; R. Afshar; B. Mégarbane

293

Improving Time to Pharmaceutical Approval: An Analysis of the Prescription Drug User Fee Act Process  

Microsoft Academic Search

The Prescription Drug User Fee Act of 1992 (PDUFA) established pharmaceutical review performance goals and authorized the US Food and Drug Administration (FDA) to collect user fees in conjunction with pharmaceutical marketing applications. There have been 3 subsequent reauthorizations of PDUFA; the most recent, referred to as PDUFA IV, was enacted with the Food and Drug Administration Amendments Act of

Andrea C. Masciale; Patricia L. DeSantis; Jay P. Siegel

2012-01-01

294

21 CFR 201.57 - Specific requirements on content and format of labeling for human prescription drug and...  

Code of Federal Regulations, 2010 CFR

...prescription or over-the-counter drugs, classes of drugs, or foods...hepatic impairment). (10) 9 Drug abuse and dependence . This section...subsection must state the types of abuse that can occur with the drug and the adverse...

2010-04-01

295

21 CFR 201.57 - Specific requirements on content and format of labeling for human prescription drug and...  

Code of Federal Regulations, 2010 CFR

...prescription or over-the-counter drugs, classes of drugs, or foods...hepatic impairment). (10) 9 Drug abuse and dependence . This section...subsection must state the types of abuse that can occur with the drug and the adverse...

2009-04-01

296

21 CFR 201.57 - Specific requirements on content and format of labeling for human prescription drug and...  

Code of Federal Regulations, 2010 CFR

21 Food and Drugs 4 2007-04-01 2007-04-01...format of labeling for human prescription drug and biological products described in Ã... 201.57 Section 201.57 Food and Drugs FOOD AND DRUG ADMINISTRATION,...

2007-04-01

297

21 CFR 201.57 - Specific requirements on content and format of labeling for human prescription drug and...  

Code of Federal Regulations, 2010 CFR

21 Food and Drugs 4 2008-04-01 2008-04-01...format of labeling for human prescription drug and biological products described in Ã... 201.57 Section 201.57 Food and Drugs FOOD AND DRUG ADMINISTRATION,...

2008-04-01

298

Experts' agency problems: evidence from the prescription drug market in Japan.  

PubMed

This article examined the physician-patient agency relationship in the context of the prescription drug market in Japan. In this market, physicians often both prescribe and dispense drugs and can pocket profits in so doing. A concern is that, due to the incentive created by the mark-up, physicians' prescription decisions may be distorted. Empirical results using anti-hypertensive drugs suggest that physicians' prescription choices are influenced by the mark-up. However, physicians are also sensitive to the patient's out-of-pocket costs. Overall, although the mark-up affects prescription choices, physicians appear more responsive to the patient's out-of-pocket costs than their own profits from mark-up. PMID:18478669

Iizuka, Toshiaki

2007-01-01

299

Prescription opioid abuse among drug-involved street-based sex workers.  

PubMed

National population surveys and individual studies over the past decade have documented the escalating abuse of a variety of prescription medications, particularly prescription opioids. Although surveillance data provide important information for estimating the prevalence of prescription opioid abuse in the general population, studies documenting the patterns of prescription drug abuse among chronic street-drug-using populations are extremely rare. This paper examines the abuse of prescription opioids among drug-involved street-based sex workers in Miami, Florida. The data for this study were drawn from an ongoing HIV intervention trial initiated in 2001, designed to test the relative effectiveness of two alternative HIV prevention protocols for this population. Participants in the study were recruited through traditional targeted sampling strategies, and complete data are available on 588 street-based sex workers. In terms of prescription drug abuse, 12.2 percent of the sample reported using at least one opioid analgesic in the past 90 days without having a legitimate prescription. Logistic regression analyses were conducted to examine the associations between prescription opioid abuse and its predictors. In the multivariate model, factors positively associated with prescription opioid abuse included: Caucasian race (OR = 2.53; 95 percent CI 1.30 to 4.91), current powder cocaine use (OR = 2.28; 95 percent CI 1.28 to 4.08), current heroin use (OR = 2.08; 95 percent CI 1.10 to 3.92), 90-day physical abuse/victimization (OR = 2.07; 95percent CI 1.18 to 3.61), and shorter sex-work involvement (OR = 1.98; 95 percent CI 1.13 to 3.48). In contrast, daily crack smoking was negatively associated with prescription opioid abuse (OR = 0.61; 95 percent CI 0.33 to 1.10). This study provides some of the first empirical evidence to indicate that prescription opioid abuse is emerging in a heretofore unstudied community of marginalized drug-using sex workers. In addition, data on this population's mechanisms of access to prescription opioids clearly suggest that there is an active black market for these drugs. These findings warrant intensive study to determine the relative contribution of each mechanism of diversion to the illicit market. PMID:17319260

Surratt, Hilary L; Inciardi, James A; Kurtz, Steven P

300

Literacy demands of product information intended to supplement television direct-to-consumer prescription drug advertisements  

Microsoft Academic Search

The US Food and Drug Administration (FDA) allows television direct-to-consumer (DTC) prescription drug advertisements that do not fully disclose drug risks if the ads include “adequate provision” for dissemination of the drug’s approved labeling. This requirement can be met in part by referring consumers to multiple text sources of product labeling. This study was designed to assess the materials to

Kimberly A. Kaphingst; Rima E. Rudd; William DeJong; Lawren H. Daltroy

2004-01-01

301

Screening for Drug Abuse Among Medical and Nonmedical Users of Prescription Drugs in a Probability Sample of College Students  

PubMed Central

Objectives To determine the prevalence of medical and nonmedical use of 4 classes of prescription drugs (opioid, stimulant, sleeping, and sedative or anxiety) and to assess probable drug abuse among 4 mutually exclusive groups of medical and nonmedical use of prescription drugs. Design In 2005, a Web survey was self-administered by a probability sample of 3639 college students (68% response rate). Setting A large, midwestern 4-year university. Participants The sample had a mean age of 19.9 years, and respondents were 53.6% female, 67.4% white, 12.1% Asian, 6.0% African American, 4.2% Hispanic, and 10.2% other racial categories. Main Outcome Measures Medical and nonmedical use of prescription drugs was measured. Probable drug abuse was assessed using a modified version of the Drug Abuse Screening Test, Short Form. Results A total of 40.1% of respondents reported no lifetime use of at least 1 of 4 classes of prescription drugs, 39.7% reported medical use only, 15.8% reported both medical and nonmedical use, and 4.4% reported nonmedical use only. The odds of a positive screening result for drug abuse were greater among medical and nonmedical users (adjusted odds ratio, 5.5; 95% confidence interval, 3.4–7.3) and nonmedical users only (adjusted odds ratio, 6.5; 95% confidence interval, 4.0–10.6) compared with nonusers. The odds of a positive screening result for drug abuse did not differ between medical users only and nonusers. Conclusions Nonmedical users of prescription drugs are at heightened risk for drug abuse, whereas medical users without a history of nonmedical use are generally not at increased risk. Drug abuse screening should be routine for college students, especially among individuals with any history of nonmedical use of prescription drugs.

McCabe, Sean Esteban

2008-01-01

302

Individual, partner, and relationship factors associated with nonmedical use of prescription drugs  

PubMed Central

Introduction The nonmedical use of prescription drugs (NMUPD) has become increasingly problematic in the United States. A variety of individual-level risk factors have been investigated for their role in prescription drug misuse; however, much less work has considered other factors that may relate to increased risk for the nonmedical use of prescription drugs. Aims The objective of the current report was to examine individual, partner, and relationship factors (e.g., relationship satisfaction) associated with the NMUPD in a community sample of married adults. Methods The current report used two waves of data from an ongoing study of couples who were recruited at the time they applied for their marriage license and are now in the 10th year of follow-up. Logistic regression models examined the relation between individual, partner, and relationship factors and NMUPD. Results Among wives, there was evidence that a partner’s prescription drug use and relationship factors were associated with increased risk for nonmedical use of prescription drugs. There was some evidence that suggested that it was the increased access or availability, and not the partner’s use per se, that was related to the nonmedical use of prescription drugs. These results persisted after controlling for other illicit drug use, heavy drinking, depressive symptomatology, and sociodemographic factors. Among men, neither partner use nor relationship factors were associated with nonmedical use of prescription drugs after considering the impact of individual-level risk factors. Discussion In addition to individual-level risk factors, intervention and prevention efforts should also consider the potential influence of partner and relationship factors.

Leonard, Kenneth E.; Cornelius, Jack R.

2013-01-01

303

Calcium carbonate overdose  

MedlinePLUS

Tums overdose; Calcium overdose ... Calcium ... Products containing calcium carbonate, including Certain antacids (Tums, Chooz) Certain mineral supplements Certain hand lotions Certain vitamin and mineral supplements Note: ...

304

Prescription Drugs: HCFA's (Health Care Financing Administration) Proposed Drug Utilization Review System Ignores Quality of Care Issues.  

National Technical Information Service (NTIS)

Most elderly individuals find that prescription drugs, as well as over-the-counter drugs, are critical to the overall effectiveness of their health care. In a recent report from the Office of the Surgeon General, drugs have been called an essential compon...

1989-01-01

305

Concomitant prescription of non-steroidal anti-inflammatory drugs and antacids in the outpatient setting of a medical center in Taiwan: a prescription database study  

Microsoft Academic Search

Objective: Although antacids were ineffective in preventing serious gastrointestinal complications caused by non-steroidal anti-inflammatory drugs (NSAIDs), many physicians in Taiwan still prescribe antacids concomitantly with NSAIDs. A survey of an outpatient prescription database was performed to measure the extent of such a combination and to explore its associated factors. Methods: One month of the outpatient prescription data in the polyclinic

Jui-Yao Liu; Tzeng-Ji Chen; Shinn-Jang Hwang

2001-01-01

306

Medical Use, Illicit Use, and Diversion of Abusable Prescription Drugs  

Microsoft Academic Search

The authors investigated the medical use, illicit use, and diversion of 4 distinct classes of abusable prescription medication (sleeping medication, sedative or anxiety medication, stimulant medication, and pain medication) in a random sample of undergraduate students. In spring 2003, 9, 161 undergraduate students attending a large, public, midwestern research university in the United States self-administered a Web-based survey. The prevalence

Sean Esteban McCabe; Christian J. Teter; Carol J. Boyd

2006-01-01

307

Racial Disparities in Prescription Drug Use Among Dually Eligible Beneficiaries  

Microsoft Academic Search

Well-documented racial disparities in use of medical services raise concerns about such disparities in other aspects of health care. We compare the dif ference in Medicaid pharmacy use between black and white dually eligible Medicare beneficia- ries. Controlling for the presence of chronic illnesses, we find that black beneficiaries have significantly fewer prescriptions filled and lower pharmacy costs in 8

Jennifer Schore; Randall Brown; Bridget Lavin

2004-01-01

308

Medical and Nonmedical Users of Prescription Drugs among College Students  

ERIC Educational Resources Information Center

|Objectives: To examine medical and nonmedical users of prescription opioids, central nervous system depressants, and stimulants taken individually and in combination. Participants: Undergraduates at an urban mid-Atlantic university with 12,000 students. Methods: A questionnaire administered in classes provided 413 responses, with a usable…

Rozenbroek, Katelyn; Rothstein, William G.

2011-01-01

309

Fluoride overdose  

MedlinePLUS

... is found in many over-the-counter and prescription products, including: Certain mouthwashes and toothpastes Certain vitamins (Tri-Vi-Flor, Poly-Vi-Flor, Vi-Daylin F) Fluoridated water Sodium fluoride liquid and tablets Fluoride may also ...

310

Suicide by gabapentin overdose.  

PubMed

Gabapentin is an antiepileptic drug that is prescribed for both FDA-approved and multiple off-label conditions, and has a relatively safe side-effect profile. Rare cases of overdose-related adverse effects have been reported in the literature. Described herein are the circumstances and autopsy findings of a 62-year-old woman with a history of depression, whose death was caused by intentional ingestion of excess gabapentin. The postmortem peripheral blood gabapentin concentration as determined by high-performance liquid chromatography/tandem mass spectroscopy was 88 ?g/mL. Previously reported cases of individuals surviving gabapentin overdoses are discussed and compared with this case. Based on a review of the available literature, this appears to be the first published report of a death due solely to gabapentin toxicity. PMID:21554310

Middleton, Owen

2011-05-06

311

Management of human resources associated with misuse of prescription drugs: analysis of a national survey.  

PubMed

Nonmedical use of prescription drugs is increasingly prevalent in the United States, but limited research is available on prescription drugs misuse in the workforce. We investigated whether absenteeism and turnover are associated with having problems linked to prescription drug misuse among employees. We also further explored the moderating effects of employee drug policy and testing on the relation between having problems linked to misuse of prescription pain relievers (PPRs) and absenteeism and turnover. This is a cross-sectional study (n = 2,249) using the 2007 U.S. national survey data ("National Survey on Drug Use and Health"). The multivariate logistic analysis results illustrate, after controlling confounding factors (gender, age, tobacco use, and heroin use), absenteeism and turnover linked to having problems of PPRs misuse. Our findings suggest the moderating effects of employee drug policy on the association between absenteeism and turnover and having problems linked to misuse of PPRs. Also, drug testing was found to moderate the link between having negative outcomes of misuse of PPRs and absenteeism. Having problems associated with misuse of PPRs is linked to absenteeism and turnover. A drug policy program including drug testing may play a significant role in reducing absenteeism and turnover in relation to having problems linked to misuse of PPRs. PMID:22106546

Lee, Doohee; Ross, Michael W

2011-01-01

312

Simultaneous and Concurrent Polydrug Use of Alcohol and Prescription Drugs: Prevalence, Correlates, and Consequences*  

PubMed Central

Objective In this study, we sought to examine the prevalence, correlates, and consequences associated with simultaneous polydrug use and concurrent polydrug use of alcohol and prescription drugs. For purposes of this investigation, simultaneous polydrug use referred to the co-ingestion of different drugs at the same time, and concurrent polydrug use referred to the use of different drugs on separate occasions within the past 12 months. Method Undergraduate students attending a large public midwestern university in the United Sates were randomly selected to self-administer a Web survey. The sample consisted of 4,580 undergraduate students, with a mean (SD) age of 19.9 (2.0) years; the sample consisted of 50% women, and the racial breakdown was 65% while, 13% Asian, 7% black, 5% Hispanic, and 10% other race/ethnicity. The survey assessed simultaneous polydrug use and concurrent polydrug use of alcohol and four classes of prescription drugs: (1) pain medication, (2) stimulant medication, (3) sedative medication, and (4) sleeping medication. Results The 12 month prevalence for polydrug use involving alcohol and abusable prescription drugs was 12.1% (including 6.9% simultaneous polydrug use). The majority of polydrug use involving alcohol and each class of prescription drugs was simultaneous polydrug use, with the exception of sleeping medication. Simultaneous polydrug use was more prevalent among undergraduate students who were male, were white, and reported early initiation of alcohol use. Simultaneous polydrug was associated with more alcohol-related and other drug use-related problems than concurrent polydrug use. Conclusions Based on the high prevalence and increased risk for consequences associated with simultaneous polydrug use of alcohol and prescription drugs, collegiate prevention efforts aimed at reducing substance abuse should clearly focus on co-ingestion of alcohol and prescription drugs.

McCABE, SEAN ESTEBAN; CRANFORD, JAMES A.; MORALES, MICHELE; YOUNG, AMY

2006-01-01

313

Desisting From Prescription Drug Abuse: An Application of Growth Models to Rx Opioid Users.  

PubMed

Modern desistance research has examined many facets of desistance, in terms of theoretical predictors of desistance and recidivism, and in terms of differing types of offending. Though predicting desistance from illegal drug use is among these topics, no research to date has examined the predictors of desisting from prescription opioid abuse. This study uses longitudinal data from 318 prescription opioid users to analyze the effects of various predictors of desistance on declining nonmedical prescription opioid use, with an emphasis on gender differences among participants. Results indicate that theoretical and demographic characteristics correspond with differing rates of decline and further vary by gender. PMID:22736809

Gunter, Whitney D; Kurtz, Steven P; Bakken, Nicholas W; O'Connell, Daniel J

2012-01-01

314

Preventing drug interactions by online prescription screening in community pharmacies and medical practices  

Microsoft Academic Search

Background: Drug interactions have been shown to be preventable by computerized prescription entry and screening only in hospitals and not in community-based practice.Methods: We retrospectively evaluated the effect of online prescription screening in community pharmacies and physician offices of one health maintenance organization, phased in during 3 consecutive 6-month periods in 1998 to 1999 (period I, system active only in

Hillel Halkin; Itzhak Katzir; Irena Kurman; Joseph Jan; Becky Ben-Oz Malkin

2001-01-01

315

The Drug Facts Box: Improving the communication of prescription drug information.  

PubMed

Communication about prescription drugs ought to be a paragon of public science communication. Unfortunately, it is not. Consumers see $4 billion of direct-to-consumer advertising annually, which typically fails to present data about how well drugs work. The professional label-the Food and Drug Administration's (FDA) mechanism to get physicians information needed for appropriate prescribing-may also fail to present benefit data. FDA labeling guidance, in fact, suggests that industry omit benefit data for new drugs in an existing class and for drugs approved on the basis of unfamiliar outcomes (such as depression rating scales). The medical literature is also problematic: there is selective reporting of favorable trials, favorable outcomes within trials, and "spinning" unfavorable results to maximize benefit and minimize harm. In contrast, publicly available FDA reviews always include the phase 3 trial data on benefit and harm, which are the basis of drug approval. However, these reviews are practically inaccessible: lengthy, poorly organized, and weakly summarized. To improve accessibility, we developed the Drug Facts Box: a one-page summary of benefit and harm data for each indication of a drug. A series of studies-including national randomized trials-demonstrates that most consumers understand the Drug Facts Box and that it improves decision-making. Despite calls from their own Risk Communication Advisory Committee and Congress (in the Affordable Care Act) to consider implementing boxes, the FDA announced it needs at least 3-5 y more to make a decision. Given its potential public health impact, physicians and the public should not have to wait that long for better drug information. PMID:23942130

Schwartz, Lisa M; Woloshin, Steven

2013-08-13

316

The Drug Facts Box: Improving the communication of prescription drug information  

PubMed Central

Communication about prescription drugs ought to be a paragon of public science communication. Unfortunately, it is not. Consumers see $4 billion of direct-to-consumer advertising annually, which typically fails to present data about how well drugs work. The professional label—the Food and Drug Administration's (FDA) mechanism to get physicians information needed for appropriate prescribing—may also fail to present benefit data. FDA labeling guidance, in fact, suggests that industry omit benefit data for new drugs in an existing class and for drugs approved on the basis of unfamiliar outcomes (such as depression rating scales). The medical literature is also problematic: there is selective reporting of favorable trials, favorable outcomes within trials, and “spinning” unfavorable results to maximize benefit and minimize harm. In contrast, publicly available FDA reviews always include the phase 3 trial data on benefit and harm, which are the basis of drug approval. However, these reviews are practically inaccessible: lengthy, poorly organized, and weakly summarized. To improve accessibility, we developed the Drug Facts Box: a one-page summary of benefit and harm data for each indication of a drug. A series of studies—including national randomized trials—demonstrates that most consumers understand the Drug Facts Box and that it improves decision-making. Despite calls from their own Risk Communication Advisory Committee and Congress (in the Affordable Care Act) to consider implementing boxes, the FDA announced it needs at least 3–5 y more to make a decision. Given its potential public health impact, physicians and the public should not have to wait that long for better drug information.

Schwartz, Lisa M.; Woloshin, Steven

2013-01-01

317

A Decade of Controversy: Balancing Policy With Evidence in the Regulation of Prescription Drug Advertising  

PubMed Central

Direct-to-consumer advertising (DTCA) of prescription drugs has remained controversial since regulations were liberalized by the Food and Drug Administration in 1997. We reviewed empirical evidence addressing the claims made in the policy debate for and against DTCA. This advertising has some benefits, but significant risks are evident as well, magnified by the prominence of DTCA in population-level health communications. To minimize potential harm and maximize the benefits of DTCA for population health, the quality and quantity of information should be improved to enable consumers to better self-identify whether treatment is indicated, more realistically appraise the benefits, and better attend to the risks associated with prescription drugs. We propose guidelines for improving the utility of prescription drug advertising.

Grande, David; Tarn, Derjung M.; Kravitz, Richard L.

2010-01-01

318

A decade of controversy: balancing policy with evidence in the regulation of prescription drug advertising.  

PubMed

Direct-to-consumer advertising (DTCA) of prescription drugs has remained controversial since regulations were liberalized by the Food and Drug Administration in 1997. We reviewed empirical evidence addressing the claims made in the policy debate for and against DTCA. This advertising has some benefits, but significant risks are evident as well, magnified by the prominence of DTCA in population-level health communications. To minimize potential harm and maximize the benefits of DTCA for population health, the quality and quantity of information should be improved to enable consumers to better self-identify whether treatment is indicated, more realistically appraise the benefits, and better attend to the risks associated with prescription drugs. We propose guidelines for improving the utility of prescription drug advertising. PMID:19910354

Frosch, Dominick L; Grande, David; Tarn, Derjung M; Kravitz, Richard L

2010-01-01

319

Prescription drug use during pregnancy: a population-based study in Regione Emilia-Romagna, Italy  

Microsoft Academic Search

Purpose  Drug utilization studies in pregnant women are crucial to inform pharmacovigilance efforts in human teratogenicity. The purpose\\u000a of this study was to estimate the prevalence of prescription drug use among pregnant women in Regione Emilia-Romagna (RER),\\u000a Italy.\\u000a \\u000a \\u000a \\u000a Methods  We conducted a retrospective prevalence study using data from the RER health care database. Outpatient prescription drug data\\u000a were reconciled for RER residents

Joshua J. Gagne; Vittorio Maio; Vincenzo Berghella; Daniel Z. Louis; Joseph S. Gonnella

2008-01-01

320

EFFECTS OF IMAGE CONGRUENCY ON PERSUASIVENESS AND RECALL IN DIRECT-TO-CONSUMER PRESCRIPTION DRUG ADVERTISING  

Microsoft Academic Search

Although direct-to-consumer (DTC) prescription drug advertising is regulated by the U.S. Food and Drug Administration, content analyses (Baird-Harris, 2009; Frosch, Krueger, Hornik, Cronbolm, & Berg, 2007; Kaphingst, DeJong, Rudd, & Daltroy, 2004; Wilkes, Bell, & Kravitz, 2000) and other studies (Davis, 2000, 2007) have suggested that advertisers may not disclose drug risks to the same extent that they describe drug

Kristen M. Kiernicki

2012-01-01

321

The effect of instruction on comprehension and recall of prescription drug label information in older adults  

Microsoft Academic Search

Older adults are the fastest growing segment of the population. They consume the largest quantities of prescription and nonprescription medication compared to other age groups, often using drugs on a daily basis over extended periods of time. They are prime candidates for many types of medication errors often as a result of an inadequate understanding of the drug regimen, misinterpreting

Maria Kostyniuk Daniv

1992-01-01

322

21 CFR 202.1 - Prescription-drug advertisements.  

Code of Federal Regulations, 2010 CFR

...composition, when, in fact, the drug or ingredient is...widely publicized in medical literature, the Food and Drug Administration shall...Referenceâ) for use by medical practitioners, pharmacists...nurses, containing drug information...

2010-04-01

323

21 CFR 202.1 - Prescription-drug advertisements.  

Code of Federal Regulations, 2010 CFR

...composition, when, in fact, the drug or ingredient is...widely publicized in medical literature, the Food and Drug Administration shall...Referenceâ) for use by medical practitioners, pharmacists...nurses, containing drug information...

2009-04-01

324

Prevalence and predictors of non-medical prescription drug use among men who have sex with men  

Microsoft Academic Search

Although non-medical prescription drug use has dramatically increased in many populations during the past decade, this phenomenon remains understudied among men who have sex with men (MSM). Using a community-based sample of MSM, we provide data on the high prevalence of lifetime and recent non-medical prescription drug use among MSM for a range of prescription drug classes such as pain

Brian C. Kelly; Jeffrey T. Parsons

2010-01-01

325

21 CFR 369.3 - Warnings required on drugs exempted from prescription-dispensing requirements of section 503(b)(1...  

Code of Federal Regulations, 2013 CFR

...SERVICES (CONTINUED) DRUGS FOR HUMAN USE INTERPRETATIVE...STATEMENTS RE WARNINGS ON DRUGS AND DEVICES FOR OVER-THE-COUNTER SALE Definitions and Interpretations...Warnings required on drugs exempted from prescription-dispensing...

2013-04-01

326

Income-based drug benefit policy: impact on receipt of inhaled corticosteroid prescriptions by Manitoba children with asthma  

Microsoft Academic Search

Background: Drug benefit policies are an important determinant of a population's use of prescription drugs. This study was undertaken to determine whether a change in a provincial drug benefit policy, from a fixed deductible and copayment system to an income-based deductible system, resulted in changes in receipt of prescriptions for inhaled corticosteroids by Manitoba children with asthma. Methods: Using Manitoba's

Anita L. Kozyrskyj; Cameron A. Mustard; Mary S. Cheang; F. Estelle; R. Simons

327

Prevalence of Illicit Use and Abuse of Prescription Stimulants, Alcohol, and Other Drugs Among College Students: Relationship with Age at Initiation of Prescription Stimulants  

PubMed Central

Study Objective To examine associations between age at initiation of prescription stimulants and illicit use and abuse of prescription stimulants, alcohol, and other drugs among college students in the United States. Design Web-based survey of college students. Setting A large (full-time undergraduate population > 20,000) university. Intervention A Web-based survey was sent to a random sample of 5389 undergraduate college students plus an additional 1530 undergraduate college students of various ethnic backgrounds over a 2-month period. Measurements and Main Results Alcohol abuse was assessed by including a modified version of the Cut Down, Annoyance, Guilt, Eye-opener (CAGE) instrument. Drug use–related problems were assessed with a slightly modified version of the Drug Abuse Screening Test, short form (DAST-10). The final sample consisted of 4580 undergraduate students (66% response rate). For the analyses, five subgroups were created based on age at initiation of prescription stimulant use: no prescription stimulant use, grades kindergarten (K)–4, grades 5–8, grades 9–12, and college. Undergraduate students to whom stimulants were prescribed in grades K–4 reported similar rates of alcohol and other drug use compared with that of the group that had no prescription stimulant use. For example, students who started prescription stimulants in grades K–4 were no more likely to report coingestion of alcohol and illicit prescription stimulants (odds ratio [OR] 1.4, 95% confidence interval [CI] 0.2–11.5, NS] than the group that had no prescription stimulant use. However, undergraduate students whose prescription stimulant use began in college had significantly higher rates of alcohol and other drug use. For example, students who started a prescription stimulant in college were almost 4 times as likely (OR 3.7, 95% CI 1.9–7.1, p < 0.001) to report at least three positive indicators of drug abuse on the DAST-10 compared with the group that had no prescription stimulant use. Conclusions In concordance with results of previous research, these results indicate that initiation of prescription stimulants during childhood is not associated with increased future use of alcohol and other drugs.

Kaloyanides, Kristy B.; McCabe, Sean E.; Cranford, James A.; Teter, Christian J.

2008-01-01

328

Effects of the German reference drug program on ex-factory prices of prescription drugs: a panel data approach  

Microsoft Academic Search

This paper examines effects of the German social health insurance system's reference drug program (RDP) for prescription drugs on ex-factory prices. Moreover, we analyze whether manufacturers adapt prices of their products that are not subject to reference pricing as a consequence of changes in reference prices of their products that are subject to reference pricing. We use econometric panel data

Boris Augurzky; Silja Göhlmann; Stefan Greß; Jürgen Wasem

2009-01-01

329

Mechanisms of prescription drug diversion among impaired physicians.  

PubMed

The diversion of medications by physicians is a seldom discussed problem in the United States. A better understanding of the mechanisms of diversion could assist decision makers as they develop preventive policies. To identify these mechanisms, nine focus groups of physicians undergoing monitoring for substance abuse by a state-based physician health program were conducted. The content analysis revealed that physicians divert medications by stealing from the office or hospital, by defrauding patients and insurers, by using medication samples, and by misusing valid prescriptions. The implementation of policy interventions targeting these mechanisms has the potential to mitigate the amount of physician diversion that occurs. PMID:21745042

Cummings, Simone Marie; Merlo, Lisa; Cottler, Linda

330

Prescription drug use during pregnancy in developed countries: a systematic review  

PubMed Central

Purpose To review the literature describing patterns of out-patient prescription drug use during pregnancy by therapeutic category, potential for fetal harm, and overall. Methods We conducted a systematic review of peer-reviewed literature published from 1989 to 2010. We included studies evaluating individual-level exposures to prescription medicines during pregnancy. We selected only studies conducted in developed (OECD) countries and published in English. Results Published drug utilization studies reveal wide variation in estimates of overall prescription drug use in pregnancy (27% to 93% of pregnant women filling at least one prescription excluding vitamins and minerals). Among studies of similar design, estimates were lowest in Northern European countries (44% to 47%) and highest in France (93%) and Germany (85%). Measured rates of use of contraindicated medicines in pregnancy ranged from 0.9% (Denmark; 1991–1996) to 4.6% (USA; 1996–2000). The use of medicines with positive evidence of risk (FDA category D) ranged from 2.0% (Italy; 2004) to 59.3% (France; 1995–2001). Conclusion Avoidable inconsistencies in study design and reporting attenuate conclusions that can be drawn from the literature on antenatal drug utilization. Nevertheless, the body of published research shows that antenatal prescription drug use is common, with many studies finding that a majority of women use one or more prescription medicine during pregnancy. Similarly, studies consistently report the use of drugs recognized as having potential risks in pregnancy. Given this widespread use, it is particularly important to develop standards for calculating and reporting antenatal exposures to improve the value of future research in this area.

Daw, Jamie R; Hanley, Gillian E; Greyson, Devon L; Morgan, Steven G

2012-01-01

331

An Exploration of the Relationship between the Use of Methamphetamine and Prescription Drugs.  

PubMed

This study examines patterns of use of prescription drugs and methamphetamine. We drew our sample from a study about 130 active and inactive methamphetamine users and focused on 16 participants with a recent history of methamphetamine and prescription drug use. We collected in-depth interviews to explore relationships in use trajectory patterns. The qualitative methods we used in this study followed the constant comparison process developed by grounded theory methods and analytical ethnography, which is based on familiarity with the social setting and developing propositions while conducting a research study. We used a triangulation of methods and analysis and included qualitative data, such as participant observation notes and in-depth interviews, as well as quantitative data that we collected in drug history matrices. Five themes emerged from the coding of the interview transcripts: (1) sequential polydrug use; (2) concurrent polydrug use (3) temporary substitution of preferred drug; (4) consequential-based use; and (5) switching from using methamphetamine to using prescription drugs. The trajectory patterns of methamphetamine and prescription drug use complicates treatment significantly. PMID:23285312

Lamonica, Aukje K; Boeri, Miriam

2012-01-01

332

An Exploration of the Relationship between the Use of Methamphetamine and Prescription Drugs  

PubMed Central

This study examines patterns of use of prescription drugs and methamphetamine. We drew our sample from a study about 130 active and inactive methamphetamine users and focused on 16 participants with a recent history of methamphetamine and prescription drug use. We collected in-depth interviews to explore relationships in use trajectory patterns. The qualitative methods we used in this study followed the constant comparison process developed by grounded theory methods and analytical ethnography, which is based on familiarity with the social setting and developing propositions while conducting a research study. We used a triangulation of methods and analysis and included qualitative data, such as participant observation notes and in-depth interviews, as well as quantitative data that we collected in drug history matrices. Five themes emerged from the coding of the interview transcripts: (1) sequential polydrug use; (2) concurrent polydrug use (3) temporary substitution of preferred drug; (4) consequential-based use; and (5) switching from using methamphetamine to using prescription drugs. The trajectory patterns of methamphetamine and prescription drug use complicates treatment significantly.

Lamonica, Aukje K.; Boeri, Miriam

2012-01-01

333

Popular Prescription Drugs Hitting the Market in Generic Form  

Center for Drug Evaluation (CDER)

... Have in the application documentation of the complete chemistry, manufacturing, and controls of the drug product, for each step of the ... More results from www.fda.gov/drugs/resourcesforyou/specialfeatures

334

Insurance Coverage of Prescription Drugs and the Rural Elderly  

ERIC Educational Resources Information Center

|Rural impacts of a Medicare drug benefit will ultimately depend on the number of elderly who are currently without drug coverage, new demand by those currently without coverage, the nature of the new benefit relative to current benefits, and benefit design. Purpose: To enhance understanding of drug coverage among rural elderly Medicare…

Mueller, Curt; Schur, Claudia

2004-01-01

335

Prescription Drugs Associated with Reports of Violence Towards Others  

PubMed Central

Context Violence towards others is a seldom-studied adverse drug event and an atypical one because the risk of injury extends to others. Objective To identify the primary suspects in adverse drug event reports describing thoughts or acts of violence towards others, and assess the strength of the association. Methodology From the Food and Drug Administration (FDA) Adverse Event Reporting System (AERS) data, we extracted all serious adverse event reports for drugs with 200 or more cases received from 2004 through September 2009. We identified any case report indicating homicide, homicidal ideation, physical assault, physical abuse or violence related symptoms. Main Outcome Measures Disproportionality in reporting was defined as a) 5 or more violence case reports, b) at least twice the number of reports expected given the volume of overall reports for that drug, c) a ?2 statistic indicating the violence cases were unlikely to have occurred by chance (p<0.01). Results We identified 1527 cases of violence disproportionally reported for 31 drugs. Primary suspect drugs included varenicline (an aid to smoking cessation), 11 antidepressants, 6 sedative/hypnotics and 3 drugs for attention deficit hyperactivity disorder. The evidence of an association was weaker and mixed for antipsychotic drugs and absent for all but 1 anticonvulsant/mood stabilizer. Two or fewer violence cases were reported for 435/484 (84.7%) of all evaluable drugs suggesting that an association with this adverse event is unlikely for these drugs. Conclusions Acts of violence towards others are a genuine and serious adverse drug event associated with a relatively small group of drugs. Varenicline, which increases the availability of dopamine, and antidepressants with serotonergic effects were the most strongly and consistently implicated drugs. Prospective studies to evaluate systematically this side effect are needed to establish the incidence, confirm differences among drugs and identify additional common features.

Moore, Thomas J.; Glenmullen, Joseph; Furberg, Curt D.

2010-01-01

336

Ethnic differences in the use of prescription drugs: a cross-sectional analysis of linked survey and administrative data  

PubMed Central

Background Evidence from the United States and Europe suggests that the use of prescription drugs may vary by ethnicity. In Canada, ethnic disparities in prescription drug use have not been as well documented as disparities in the use of medical and hospital care. We conducted a cross-sectional analysis of survey and administrative data to examine needs-adjusted rates of prescription drug use by people of different ethnic groups. Methods For 19 370 non-Aboriginal people living in urban areas of British Columbia, we linked data on self-identified ethnicity from the Canadian Community Health Survey with administrative data describing all filled prescriptions and use of medical services in 2005. We used sex-stratified multivariable logistic regression analysis to measure differences in the likelihood of filling prescriptions by drug class (antihypertensives, oral antibiotics, antidepressants, statins, respiratory drugs and nonsteroidal anti-inflammatory drugs [NSAIDs]). Models were adjusted for age, general health status, treatment-specific health status, socio-economic factors and recent immigration (within 10 years). Results We found evidence of significant needs-adjusted variation in prescription drug use by ethnicity. Compared with women and men who identified themselves as white, those who were South Asian or of mixed ethnicity were almost as likely to fill prescriptions for most types of medicines studied; moreover, South Asian men were more likely than white men to fill prescriptions for antibiotics and NSAIDs. The clearest pattern of use emerged among Chinese participants: Chinese women were significantly less likely to fill prescriptions for antihypertensives, antibiotics, antidepressants and respiratory drugs, and Chinese men for antidepressant drugs and statins. Interpretation We found some disparities in prescription drug use in the study population according to ethnic group. The nature of some of these variations suggest that ethnic differences in beliefs about pharmaceuticals may generate differences in prescription drug use; other variations suggest that there may be clinically important disparities in treatment use.

Morgan, Steven; Hanley, Gillian; Cunningham, Colleen; Quan, Hude

2011-01-01

337

Utility of the Electrocardiogram in Drug Overdose and Poisoning: Theoretical Considerations and Clinical Implications  

PubMed Central

The ECG is a rapidly available clinical tool that can help clinicians manage poisoned patients. Specific myocardial effects of cardiotoxic drugs have well-described electrocardiographic manifestations. In the practice of clinical toxicology, classic ECG changes may hint at blockade of ion channels, alterations of adrenergic tone, or dysfunctional metabolic activity of the myocardium. This review will offer a structured approach to ECG interpretation in poisoned patients with a focus on clinical implications and ECG-based management recommendations in the initial evaluation of patients with acute cardiotoxicity.

Yates, Christopher; Manini, Alex F

2012-01-01

338

Using classification tree modelling to investigate drug prescription practices at health facilities in rural Tanzania  

PubMed Central

Background Drug prescription practices depend on several factors related to the patient, health worker and health facilities. A better understanding of the factors influencing prescription patterns is essential to develop strategies to mitigate the negative consequences associated with poor practices in both the public and private sectors. Methods A cross-sectional study was conducted in rural Tanzania among patients attending health facilities, and health workers. Patients, health workers and health facilities-related factors with the potential to influence drug prescription patterns were used to build a model of key predictors. Standard data mining methodology of classification tree analysis was used to define the importance of the different factors on prescription patterns. Results This analysis included 1,470 patients and 71 health workers practicing in 30 health facilities. Patients were mostly treated in dispensaries. Twenty two variables were used to construct two classification tree models: one for polypharmacy (prescription of ?3 drugs) on a single clinic visit and one for co-prescription of artemether-lumefantrine (AL) with antibiotics. The most important predictor of polypharmacy was the diagnosis of several illnesses. Polypharmacy was also associated with little or no supervision of the health workers, administration of AL and private facilities. Co-prescription of AL with antibiotics was more frequent in children under five years of age and the other important predictors were transmission season, mode of diagnosis and the location of the health facility. Conclusion Standard data mining methodology is an easy-to-implement analytical approach that can be useful for decision-making. Polypharmacy is mainly due to the diagnosis of multiple illnesses.

2012-01-01

339

Aberrant drug-related behaviors: Unsystematic documentation does not identify prescription drug use disorder  

PubMed Central

Objective No evidence-based methods exist to identify prescription drug use disorder (PDUD) in primary care (PC) patients prescribed controlled substances. Aberrant drug-related behaviors (ADRBs) are suggested as a proxy. Our objective was to determine whether ADRBs documented in electronic medical records (EMRs) of patients prescribed opioids and benzodiazepines could serve as a proxy for identifying PDUD. Design A cross-sectional study of PC patients at an urban, academic medical center. Subjects 264 English-speaking patients (ages 18–60) with chronic pain (?3 months), receiving ?1 opioid analgesic or benzodiazepine prescription in the past year, were recruited during outpatient PC visits. Outcome Measures Composite International Diagnostic Interview defined DSM-IV diagnoses of past-year PDUD and no disorder. EMRs were reviewed for 15 pre-specified ADRBs (e.g. early refill, stolen medications) in the year before and after study entry. Fisher’s exact test compared frequencies of each ADRB between participants with and without PDUD. Results 61 participants (23%) met DSM-IV PDUD criteria and 203 (77%) had no disorder; 85% had one or more ADRB documented. Few differences in frequencies of individual behaviors were noted between groups, with only “appearing intoxicated or high” documented more frequently among participants with PDUD (n=10, 16%) vs. no disorder (n=8, 4%), p=0.002. The only common ADRB, “emergency visit for pain,” did not discriminate between those with and without the disorder (82% PDUD vs. 78% no disorder, p=0.6). Conclusions EMR documentation of ADRBs is common among PC patients prescribed opioids or benzodiazepines, but unsystematic clinician documentation does not identify PDUDs. Evidence-based approaches are needed.

Meltzer, Ellen C.; Rybin, Dennis; Meshesha, Lidia Z.; Saitz, Richard; Samet, Jeffrey H.; Rubens, Sonia L.; Liebschutz, Jane M.

2012-01-01

340

Inequity in publicly funded physician care: what is the role of private prescription drug insurance?  

PubMed

This study examines the impact that private financing of prescription drugs in Canada has on equity in the utilization of publicly financed physician services. The complementary nature of prescription drugs and physician service use alongside the reliance on private finance for drugs may induce an income gradient in the use of physicians. We use established econometric methods based on concentration curves to measure equity in physician utilization and its contributors in the province of Ontario. We find that individuals with prescription drug insurance make more physician visits than do those without insurance, and the effect on utilization is stronger for the likelihood of a visit than the conditional number of visits, and stronger for individuals with at least one chronic condition than those with no conditions. Results of the equity analyses reveal that the most important contributors to the pro-rich inequity in physician utilization are income and private prescription drug insurance, while public insurance, which covers older people and those on social assistance, has a pro-poor effect. These findings highlight that inequity in access to and use of publicly funded services may arise from the interaction with privately financed health services that are complements to the use of public services. PMID:19097042

Allin, Sara; Hurley, Jeremiah

2009-10-01

341

Understanding the incomprehensible: a guide to the new Medicare prescription drug benefit for case managers.  

PubMed

Much of the health news over the last few months has centered on problems elderly patients encounter in obtaining and effectively using the prescription drug discount cards that became available on June 1 under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. This article focuses on the next prescription drug newsmaker, Medicare Part D, that will supercede the discount cards on January 1, 2006. There are many complex issues that case managers must evaluate when assisting beneficiaries with queries about "what to do." This article attempts to clarify the "incomprehensible" twists and turns of these issues and provides access to a "Medicare Drug Prescription Benefit Calculator" that may assist the beneficiary and case manager in decision making. Case managers need to understand that there are many opposing viewpoints on this benefit, and it promises to become the subject of a major national debate. For this reason, substantial changes may occur prior to the launch of Part D. If you think discount drug cards are confusing, "you ain't seen nothin' yet!" PMID:15540074

Marshall, Carter L

342

Prescription Drugs Associated with Reports of Violence Towards Others  

Microsoft Academic Search

ContextViolence towards others is a seldom-studied adverse drug event and an atypical one because the risk of injury extends to others.ObjectiveTo identify the primary suspects in adverse drug event reports describing thoughts or acts of violence towards others, and assess the strength of the association.MethodologyFrom the Food and Drug Administration (FDA) Adverse Event Reporting System (AERS) data, we extracted all

Thomas J. Moore; Joseph Glenmullen; Curt D. Furberg; Joseph S. Ross

2010-01-01

343

Structure-based discovery of prescription drugs that interact with the norepinephrine transporter, NET.  

PubMed

The norepinephrine transporter (NET) transports norepinephrine from the synapse into presynaptic neurons, where norepinephrine regulates signaling pathways associated with cardiovascular effects and behavioral traits via binding to various receptors (e.g., ?2-adrenergic receptor). NET is a known target for a variety of prescription drugs, including antidepressants and psychostimulants, and may mediate off-target effects of other prescription drugs. Here, we identify prescription drugs that bind NET, using virtual ligand screening followed by experimental validation of predicted ligands. We began by constructing a comparative structural model of NET based on its alignment to the atomic structure of a prokaryotic NET homolog, the leucine transporter LeuT. The modeled binding site was validated by confirming that known NET ligands can be docked favorably compared to nonbinding molecules. We then computationally screened 6,436 drugs from the Kyoto Encyclopedia of Genes and Genomes (KEGG DRUG) against the NET model. Ten of the 18 high-scoring drugs tested experimentally were found to be NET inhibitors; five of these were chemically novel ligands of NET. These results may rationalize the efficacy of several sympathetic (tuaminoheptane) and antidepressant (tranylcypromine) drugs, as well as side effects of diabetes (phenformin) and Alzheimer's (talsaclidine) drugs. The observations highlight the utility of virtual screening against a comparative model, even when the target shares less than 30% sequence identity with its template structure and no known ligands in the primary binding site. PMID:21885739

Schlessinger, Avner; Geier, Ethan; Fan, Hao; Irwin, John J; Shoichet, Brian K; Giacomini, Kathleen M; Sali, Andrej

2011-09-01

344

Hospitalizations for suicide-related drug poisonings and co-occurring alcohol overdoses in adolescents (ages 12-17) and young adults (ages 18-24) in the United States, 1999-2008: results from the Nationwide Inpatient Sample.  

PubMed

Drug poisoning is the leading method of suicide-related deaths among females and third among males in the United States. Alcohol can increase the severity of drug poisonings, yet the prevalence of alcohol overdoses in suicide-related drug poisonings (SRDP) remains unclear. Data from the Nationwide Inpatient Sample was examined to determine rates of inpatient hospital stays for SRDP and co-occurring alcohol overdoses in adolescents (ages 12-17) and young adults (ages 18-24) between 1999 and 2008. Among adolescents, there were 14,615 hospitalizations for drug poisonings in 2008, of which 72% (10,462) were suicide-related at a cost of $43 million. Rates of SRDP in this age group decreased between 1999 and 2008. The prevalence of co-occurring alcohol overdoses increased from 5% in 1999 to 7% in 2008. Among young adults, there were 32,471 hospitalizations for drug poisonings in 2008, of which 64% (20,746) were suicide-related at a cost of $110 million. Rates of SRDP did not change significantly between 1999 and 2008. The prevalence of co-occurring alcohol overdoses increased from 14% in 1999 to 20% in 2008. Thus, while rates of SRDP decreased for adolescents and remained unchanged for young adults, the prevalence of co-occurring alcohol overdoses increased for both age groups. Such hospitalizations provide important opportunities to employ intervention techniques to prevent further suicide attempts. PMID:23356834

White, Aaron M; MacInnes, Erin; Hingson, Ralph W; Pan, I-Jen

2013-01-29

345

Use of Antipsychotic Drugs in Individuals with Intellectual Disability (ID) in the Netherlands: Prevalence and Reasons for Prescription  

ERIC Educational Resources Information Center

|Background: We investigated antipsychotic drug prescription practice of Dutch ID physicians, studying prevalence of antipsychotic drug use, reasons for prescription and the relationship between these reasons and patient characteristics. Methods: A cross-sectional study of medical and pharmaceutical records in a population living in residential…

de Kuijper, G.; Hoekstra, P.; Visser, F.; Scholte, F. A.; Penning, C.; Evenhuis, H.

2010-01-01

346

The Effect of Pharmacy Benefit Manager Clinical Programs and Services on Access to Prescription Drug Benefit Coverage  

Microsoft Academic Search

This paper provides an overview of the effects of a pharmacy benefit manager's programs and services on access to prescription drug coverage. Coverage is increasingly used by prescription drug benefit plans as a means to reduce the potential for exposure to unnecessary costs of providing the benefit. Certain fundamentals must be adhered to so as to avoid creating unintended and

J. Russell Teagarden

1998-01-01

347

Teens and the Misuse of Prescription Drugs: Evidence-Based Recommendations to Curb a Growing Societal Problem  

ERIC Educational Resources Information Center

|The misuse of prescription drugs by teens in the United States is a growing public health problem. This article provides a systematic synthesis of multiple strands of literature to recommend effective prevention methods. Using a social-ecological framework, we review the scope of the problem of prescription drug use among teens. Then, we analyze…

Twombly, Eric C.; Holtz, Kristen D.

2008-01-01

348

Study of prescription of injectable drugs and intravenous fluids to inpatients in a teaching hospital in Western Nepal  

Microsoft Academic Search

Unnecessary, excessive and poor injection practices in the South East Asia region (including Nepal) have been observed previously. The authors aim to study prescription of injectable drugs to inpatients in a teaching hospital in Western Nepal. Prescription of injectable drugs (IDs) and intravenous fluids (IVFs) to inpatients discharged from the wards of the Manipal Teaching Hospital during 1st January to

Sudesh Gyawali; P Ravi Shankar; Archana Saha; Lalit Mohan

349

Prescription of controlled drugs by non-medical prescribers.  

PubMed

The Government has again promised to end the confusion over the range and use of controlled drugs by non-medical prescribers (NMPs). A recent written answer suggests that regulations allowing district nurses who are NMPs to prescribe the full range of controlled drugs will be in place by the end of October 2011. This is the third time successive governments have made such a commitment, and until it is confirmed district nurses who are independent nurse prescribers must limit their use of controlled drugs to those set out in the British National Formulary and Drug Tariff. This article sets out the limitations on an independent nurse prescriber's right to prescribe controlled drugs under current legislation. PMID:22067574

Griffith, Richard; Tengnah, Cassam

2011-11-01

350

Memory and Comprehension of Magazine-Based Prescription Drug Advertisements among Young and Old Adults  

Microsoft Academic Search

Pharmaceutical companies spend growing amounts of money marketing their products to older adults to increase both awareness and demand. Prescription drug advertising appears in magazines and on the radio, television, and internet. Magazine advertisements seem to be the most common and can be examined by readers at their own pace, making it possible for consumers to pay more attention to

L. Ty Abernathy; Carolyn E. Adams-Price

2006-01-01

351

Patterns of Medicaid Expenditures in Utah and Nevada for Prescription Drugs by Urban Rural Frontier Location  

Microsoft Academic Search

Purpose: This research examines rural vs. urban differences in cost of prescription drugs for nervous system and other therapeutic categories among Medicaid enrollees in Utah and Nevada. Data and Methods: Using enrollee For the measure of urban-rural residence, county of residence was classified into three categories: urban, rural, and frontier, based on a county's population density. To provide context to

Gulzar H. Shah

2007-01-01

352

Age and the Purchase of Prescription Drug Insurance by Older Adults  

Microsoft Academic Search

The Medicare Part D Prescription Drug Program places an unprecedented degree of choice in the hands of older adults despite concerns over their ability to make effective decisions and desire to have extensive choice in this context. While previous research has compared older adults to younger adults along these dimensions, our study, in contrast, examines how likelihood to delay decision

Helena Szrek; M. Kate Bundorf

2011-01-01

353

Entrepreneurship at the State Level: A Case of Massachusetts' Prescription Drug Program  

Microsoft Academic Search

This study examines the applicability of entrepreneurship concepts to state government. Using a case study approach, the Massachusetts' prescription drug program for seniors is illustrated through four entrepreneurship strategies: competition, community involvement and outreach, results-oriented government, and customer driven government. Findings reveal that entrepreneurship concepts have been utilized to improve access and contain costs. Massachusetts serves an example of one

Kristina L. Guo; Yesenia Sanchez

2006-01-01

354

Drug Prescription Patterns in Schizophrenia Outpatients: Analysis of Data from a German Health Insurance Fund  

Microsoft Academic Search

Introduction: The aim of this study was to investigate routine administrative data from a major German health insurance fund, Techniker Krankenkasse, which covers 5.4 million insured individuals. Using a retrospective cohort design, this study analysed data collected from patients with a hospital diagnosis of schizophrenia in 2003 (index hospitalisation) in order to evaluate prescription patterns of antipsychotic drugs. Methods: Patients

S. Weinbrenner; H.-J. Assion; T. Stargardt; R. Busse; G. Juckel; C. A. Gericke

2009-01-01

355

42 CFR 423.56 - Procedures to determine and document creditable status of prescription drug coverage.  

Code of Federal Regulations, 2012 CFR

...Prescription drug coverage under a PDP or MA-PD plan. (2) Medicaid coverage under... With the exception of PDPs and MA-PD plans under § 423.56(b)(1) and... With the exception of PDPs and MA-PD plans under § 423.56(b)(1)...

2012-10-01

356

Generic entry, price competition, and market segmentation in the prescription drug market  

Microsoft Academic Search

This paper studies the effects of generic entry on post-patent price competition for 18 prescription drugs recently exposed to competition. An independent, validating test of the “generic competition paradox” is conducted using a newly created data set. Each generic entrant is associated with an average 1% increase in the branded price. The one-way error component model accounts for intermolecular competition,

Tracy L. Regan

2008-01-01

357

Generic entry, price competition, and market segmentation in the prescription drug market  

Microsoft Academic Search

This paper studies the effects of generic entry on post-patent price competition for 18 prescription drugs recently exposed to competition. An independent, validating test of the “generic competition paradox” is conducted using a newly created data set. Each generic entrant is associated with an average 1% increase in the branded price. The one-way error component model accounts for intermolecular competition,

Tracy L. Regany

2007-01-01

358

Evaluation of drug utilization and prescribing errors in infants: A primary care prescription-based study  

Microsoft Academic Search

The purpose of this study is to evaluate the drug utilization trends and to describe the prevalence and type of medication-related prescribing errors in infants treated at primary care health centers in Bahrain. Prescriptions issued for infants were collected over a 2-week period in May 2004 from 20 health centers. Prescribing errors were classified as omission (minor and major), commission

Khalid A. J. Al Khaja; Thuraya M. Al Ansari; Awatif H. H. Damanhori; Reginald P. Sequeira

2007-01-01

359

Utilizing Business, University, and Community Resources to Target Adolescent Prescription Drug Abuse  

ERIC Educational Resources Information Center

|"Generation Rx" is a prescription drug abuse prevention strategy which includes a "toolkit" designed to be used with youth. Developed by Cardinal Health Foundation and the Ohio State University, it provides health care providers (especially pharmacists), parents, teachers, youth workers, and other community leaders with interactive tools and…

Wade-Mdivanian, R.; Anderson-Butcher, D.; Hale, K.; Kwiek, N.; Smock, J.; Radigan, D.; Lineberger, J.

2012-01-01

360

New Drug Enforcement Administration guideline for communicating controlled substance prescriptions to pharmacies.  

PubMed

The Drug Enforcement Administration (DEA) is issuing this statement of policy to provide guidance under existing law regarding the proper role of a duly authorized agent of a DEA-registered individual practitioner in connection with the communication of a controlled substance prescription to a pharmacy. PMID:21426229

2011-01-01

361

Views on Personalized Medicine: Do the Attitudes of African American and White Prescription Drug Consumers Differ?  

Microsoft Academic Search

Aims: Although recent advances in pharmacogenomics are making possible the use of genetic testing to determine the best medication for patients, little is known about how patients view such procedures. The aims for this study that were developed collaboratively as part of a community-academic partnership are: (1) What are the attitudes and perceptions of prescription drug consumers concerning personalized medicine

M. De Marco

2010-01-01

362

Intrinsic and Extrinsic Factors of Illicit Prescription Drug Use: Where You Spend Your College Years Matters  

Microsoft Academic Search

With college students' rates of illicit prescription drug use higher than any other groups, it is imperative that factors associated with use be explored. The current study aims to expand and integrate a currently disjointed literature that is predominately focused on individual characteristics. Social development model and social control theory are discussed throughout as theoretical support. A national sample of

Robyn A. Dolson

2012-01-01

363

What Constitutes Prescription Drug Misuse? Problems and Pitfalls of Current Conceptualizations  

Microsoft Academic Search

Many medications with sedative, anxiolytic, analgesic, or stimulant properties have the potential to be inappro- priately used. However, because these substances have beneficial effects, many issues pertinent to understanding prescrip- tion drug misuse may differ from those associated with other misused substances. There is currently a lack of consensus about what constitutes prescription misuse and a wide range of operational

Sean P. Barrett; Jessica R. Meisner; Sherry H. Stewart

2008-01-01

364

Willingness to pay versus price of market: demand for prescription drugs and Insurance  

Microsoft Academic Search

This paper contributes to the current debate on health system reform by assessing the impact of insurance market organization on the price of prescription drugs. In contrast to the classic model à la Rothschild\\/Stiglitz (1976), a difference exists between the monetary evaluation of the discomfort caused by the illness and the price of medication. We focus on both the adverse

Nathalie Fombaron; Carine Milcent

2005-01-01

365

Increased alcohol consumption, nonmedical prescription drug use, and illicit drug use are associated with energy drink consumption among college students  

PubMed Central

Objectives This longitudinal study examined the prevalence and correlates of energy drink use among college students, and investigated its possible prospective associations with subsequent drug use, including nonmedical prescription drug use. Methods Participants were 1,060 undergraduates from a large, public university who completed three annual interviews, beginning in their first year of college. Use of energy drinks, other caffeinated products, tobacco, alcohol, and other illicit and prescription drugs were assessed, as well as demographic and personality characteristics. Results Annual weighted prevalence of energy drink use was 22.6%wt and 36.5%wt in the second and third year of college, respectively. Compared to energy drink non-users, energy drink users had heavier alcohol consumption patterns, and were more likely to have used other drugs, both concurrently and in the preceding assessment. Regression analyses revealed that Year 2 energy drink use was significantly associated with Year 3 nonmedical use of prescription stimulants and prescription analgesics, but not with other Year 3 drug use, holding constant demographics, prior drug use, and other factors. Conclusions A substantial and rapidly-growing proportion of college students use energy drinks. Energy drink users tend to have greater involvement in alcohol and other drug use and higher levels of sensation-seeking, relative to non-users of energy drinks. Prospectively, energy drink use has a unique relationship with nonmedical use of prescription stimulants and analgesics. More research is needed regarding the health risks associated with energy drink use in young adults, including their possible role in the development of substance use problems.

Arria, Amelia M.; Caldeira, Kimberly M.; Kasperski, Sarah J.; O'Grady, Kevin E.; Vincent, Kathryn B.; Griffiths, Roland R.; Wish, Eric D.

2009-01-01

366

De-Marketing and Administrative Strategies in Prescription Drug Use.  

National Technical Information Service (NTIS)

Sub-optimal drug prescribing is a common problem whose importance has increased with the proliferation of new and potent agents and growing economic pressures to contain health care costs. A random survey of 85 internists revealed that although physicians...

J. Avorn

1982-01-01

367

Variability in prescription drug utilization: issues for research.  

PubMed Central

The authors report the results of a literature review to identify research issues relating to physician prescribing practices and evaluate the potential for existing Canadian databases to support initiatives to improve prescribing practices. Methodologies such as small-area variation analysis and drug utilization reviews are discussed, and Canadian data sources relating to drug prescribing are assessed. The authors conclude that small-area variation analysis can be used to identify differences in drug utilization rates. A ranking method to identify drugs with the greatest variability in utilization can then be used to establish priorities for further analysis. After statistically significant factors associated with prescribing patterns are identified, intervention and policy formation will be possible. This will involve a more sophisticated integration of existing provincial information sources and the adoption of uniform guidelines to promote rational prescribing practices.

Anis, A H; Carruthers, S G; Carter, A O; Kierulf, J

1996-01-01

368

Labeling for Human Prescription Drug and Biological Products ...  

Center for Biologics Evaluation and Research (CBER)

Text Version... FDA recognizes that revising labeling to comply with the PLR regulations is an excellent opportunity to update labeling content to ensure that it ... More results from www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation

369

Labeling for Human Prescription Drug and Biological Products ...  

Center for Biologics Evaluation and Research (CBER)

Text Version... Pregnancy, Labor and Delivery, Nursing Mothers, Pediatric ... 2011 Indications and Usage, Heart Failure (1.3 ... written for health care professionals and ... More results from www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation

370

75 FR 12555 - Prescription Drug User Fee Act; Public Meeting  

Federal Register 2010, 2011, 2012, 2013

...years. In 2002, Congress extended PDUFA again through fiscal year 2007 (PDUFA III) through the Public Health Security and Bioterrorism Preparedness and Response Act (Public Law 107-188). Most recently, Title I of the Food and Drug Administration...

2010-03-16

371

Prescription and Over-the-Counter Drug Product List: May ...  

Center for Drug Evaluation (CDER)

Text Version... TABLET; ORAL METRONIDAZOLE @ PAR PHARM @ WORLD GEN 500MG 500MG 001 A070039 001 A070039 Jan 29, 1985 Jan 29, 1985 May ... More results from www.fda.gov/downloads/drugs/informationondrugs

372

Frequently Asked Questions on Prescription Drug User Fees ...  

Center for Drug Evaluation (CDER)

... which is at one general physical location consisting of one or more buildings, all of which are within 5 miles of each other, and; ... More results from www.fda.gov/drugs/developmentapprovalprocess/smallbusinessassistance

373

Additions/Deletions for Prescription and OTC Drug Product ...  

Center for Drug Evaluation (CDER)

... been marketed, have been discontinued from marketing or that have had their approvals withdrawn for other than safety or efficacy reasons, will be ... More results from www.fda.gov/drugs/informationondrugs

374

How Can I End a Prescription Drug Habit Safely?  

MedlinePLUS

... states have different laws on the age when teens can get drug treatment without a parent or guardian's involvement. The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) has a ...

375

21 CFR 201.100 - Prescription drugs for human use.  

Code of Federal Regulations, 2013 CFR

...package of the drug. (7) A statement directed to the pharmacist specifying the type of container to be used in dispensing...statement of specifications which clearly enable the dispensing pharmacist to select an adequate container)â: Provided,...

2013-04-01

376

Be Smart About Prescription Drug Advertising -- Arbitraer Brief ...  

Center for Drug Evaluation (CDER)

Text Version... Arbitraer is used to treat seasonal allergy symptoms, such as runny nose, sneezing, itchy nose or throat, and itchy, watery, or red eyes. ... More results from www.fda.gov/downloads/drugs/resourcesforyou

377

Prescription of psychotropic drugs in adolescent psychiatry wards in Finland.  

PubMed

This point-prevalence study was designed to assess adolescent psychiatrists' practices of prescribing psychotropic drugs in hospital settings, and to compare the practices between the years 1991 and 1999. Data on patients' gender, age, diagnosis and psychotropic medication were obtained by means of a questionnaire sent to four hospital units in Finland. The sample represented 49% in 1991 and 29% in 1999 of all adolescent psychiatric inpatient beds in Finland. Of the patients included in the study, 30% (20/66) in 1991 and 68% (53/78) in 1999 were treated with drugs. The increase was biggest in the proportion of depressive patients and in the proportion of depressive patients receiving drugs. The results of this study suggest that the use of medication may have increased in recent years as new antidepressants and atypical neuroleptics have become available. Prescribing practices appeared to be appropriate, on the understanding that drug therapies are adjunct to other interventions. PMID:15204208

Haapasalo-Pesu, Kirsi-Maria; Erkolahti, Ritva; Saarijärvi, Simo; Aalberg, Veikko

2004-01-01

378

Presenting Risk Information in Prescription Drug and Medical ...  

Center for Biologics Evaluation and Research (CBER)

Text Version... (pp. 207-233); Shapiro, K. (Ed.) (2001) The limits of attention: Temporal constraints in ... there might not be one if a factor were considered in isolation. ... More results from www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation

379

Non-medical use of prescription drugs in a national sample of college women  

Microsoft Academic Search

Non-medical use of prescription drugs (NMUPD) is one of the fastest growing forms of illicit drug use, with research indicating that college students represent a particularly high risk population. The current study examined demographic characteristics, health\\/mental health, substance misuse, and rape experiences as potential risk correlates of NMUPD among a national sample of college women (N=2000). Interviews were conducted via

Jenna L. McCauley; Ananda B. Amstadter; Alexandra Macdonald; Carla Kmett Danielson; Kenneth J. Ruggiero; Heidi S. Resnick; Dean G. Kilpatrick

2011-01-01

380

Whom do older adults trust most to provide information about prescription drugs?  

Microsoft Academic Search

Background: Cost-related nonadherence to medieations is common among older adults, yet physician-patient communication about medication cost concerns is infrequent. One factor affecting communication and adherence may be older adults' confidence in the information about prescription drugs provided by physicians and other sources.Objectives: This study was conducted to identify which source older adults most trust to provide information on drugs and

Julie M. Donohue; Haiden A. Huskamp; Ira B. Wilson; Joel Weissman

2009-01-01

381

Ten Tips to Prevent an Accidental Overdose  

MedlinePLUS

... Health Cosmetics Dietary Supplements Drugs Food Medical Devices Nutrition Radiation-Emitting Products Tobacco Products Vaccines, Blood & Biologics Ten Tips to Prevent an Accidental Overdose Search the Consumer Updates Section Always use the cup, syringe, or ...

382

The Demise of Oregon’s Medically Needy Program: Effects of Losing Prescription Drug Coverage  

Microsoft Academic Search

BACKGROUND  In January 2003, people covered by Oregon’s Medically Needy program lost benefits owing to state budget shortfalls. The Medically\\u000a Needy program is a federally matched optional Medicaid program. In Oregon, this program mainly provided prescription drug\\u000a benefits.\\u000a \\u000a \\u000a \\u000a OBJECTIVE  To describe the Medically Needy population and determine how benefit loss affected this population’s health and prescription\\u000a use.\\u000a \\u000a \\u000a \\u000a DESIGN  A 49-question telephone survey instrument

Judy Zerzan; Tina Edlund; Lisa Krois; Jeanene Smith

2007-01-01

383

What impact do prescription drug charges have on efficiency and equity? Evidence from high-income countries  

PubMed Central

As pharmaceutical expenditure continues to rise, third-party payers in most high-income countries have increasingly shifted the burden of payment for prescription drugs to patients. A large body of literature has examined the relationship between prescription charges and outcomes such as expenditure, use, and health, but few reviews explicitly link cost sharing for prescription drugs to efficiency and equity. This article reviews 173 studies from 15 high-income countries and discusses their implications for important issues sometimes ignored in the literature; in particular, the extent to which prescription charges contain health care costs and enhance efficiency without lowering equity of access to care.

Gemmill, Marin C; Thomson, Sarah; Mossialos, Elias

2008-01-01

384

Direct-to-consumer prescription drug advertising and the public  

Microsoft Academic Search

OBJECTIVE: Drug manufacturers are intensely promoting their products directly to consumers, but the impact has not been widely studied.\\u000a Consumers’ awareness and understanding of, attitudes toward, and susceptibility to direct-to-consumer (DTC) drug advertising\\u000a were examined.\\u000a \\u000a \\u000a DESIGN: Random-digit dialing telephone survey with a random household member selection procedure (completion and response rates,\\u000a 58% and 69%, respectively).\\u000a \\u000a \\u000a \\u000a \\u000a SETTING: Respondents were interviewed while

Robert A. Bell; Richard L. Kravitz; Michael S. Wilkes

1999-01-01

385

OxyContin: Prescription Drug Abuse. CSAT Advisory.  

ERIC Educational Resources Information Center

|Recently, the media have issued numerous reports about the apparent increase in OxyContin abuse and addiction. OxyContin has been heralded as a miracle drug that allows patients with chronic pain to resume a normal life. It has also been called pharmaceutical heroin and is thought to have been responsible for a number of deaths and robberies in…

Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Substance Abuse Treatment.

386

Forces Pushing Prescription Psychotropic Drugs in College Mental Health  

ERIC Educational Resources Information Center

|A complex of forceful influences is greatly accelerating the use of what are usually referred to as "psychiatric drugs," although most prescribing is not done by psychiatrists. Many other clinicians, including other kinds of physicians, and recently psychologists, prescribe these medications. The influences contributing to this dramatic surge…

Whitaker, Leighton C.

2007-01-01

387

Audit of Psychoactive Drug Prescriptions in Group Homes.  

ERIC Educational Resources Information Center

|The survey found that of the 1,389 mentally retarded persons living in community supervised residential settings in Southwestern Ontario, 49 percent received some type of psychoactive drug. Specifically, 23 percent received anticonvulsants; 14 percent, neuroleptics; 5 percent, sedative/hypnotics; 3 percent, antidepressants; 3 percent,…

Gowdey, Charles W.; And Others

1987-01-01

388

Risk Perception of Prescription Drugs: Results of a National Survey  

Microsoft Academic Search

Understanding drug risk perceptions is a prerequisite for designing better communication materials for patients and the public and, ultimately, for ensuring the safe and effective use of pharmaceutical products. The present survey of US residents replicates and extends earlier surveys in Sweden and Canada that were designed to describe the public's perceptions of risk and benefit from the use of

Paul Slovic; Ellen Peters; John Grana; Susan Berger; Gretchen S. Dieck

2007-01-01

389

Evaluation of drug utilization and prescribing errors in infants: a primary care prescription-based study.  

PubMed

The purpose of this study is to evaluate the drug utilization trends and to describe the prevalence and type of medication-related prescribing errors in infants treated at primary care health centers in Bahrain. Prescriptions issued for infants were collected over a 2-week period in May 2004 from 20 health centers. Prescribing errors were classified as omission (minor and major), commission (incorrect information) and integration errors. Medications were classified according to the British National Formulary. In infants with a mean age of 6.5 months (+/-3.1) drugs per prescription were 2.52 (+/-1.1). Paracetamol and sodium chloride nasal drops were the topmost prescribed systemic and topical drugs, respectively. In 2282 prescriptions, 2066 (90.5%) were with omission (major), commission, and integration errors. In 54.1% of prescriptions with omission errors, length of therapy was not specified in 27.7%, and in 12.8% the dosage form was not stated. In 43.5% of prescriptions with errors of commission, dosing frequency (20.8%) and dose/strength (17.7%)-related errors were most common. Errors of integration such as potential drug-drug interaction comprised 2.4% of all prescribing errors. The proportion of drugs prescribed irrationally were: contraindicated medications, notably chlorpheniramine, promethazine, and corticosteroids (16.1%); medications prescribed on a p.r.n. basis (13.3%); missed information regarding strength of medications (2.8%); medications prescribed over extended periods (2.7%); low dosing frequency (2.6%); supratherapeutic doses (2.3%); excessive dosing frequency (0.8%). Irrational drug therapy in infants, with prescribing errors were apparent in primary care practice, which may be related to a lack of drug information, pharmacovigilance programme, and nonadherence to basic principles of prescribing. Establishing a national drug policy and pharmacovigilance programme for promoting rational drug use are to be considered. There is also a need to evaluate the effectiveness of interventions by measuring the outcomes. PMID:16930762

Al Khaja, Khalid A J; Al Ansari, Thuraya M; Damanhori, Awatif H H; Sequeira, Reginald P

2006-08-22

390

Medicare Part D and Its Effect on the Use of Prescription Drugs and Use of Other Health Care Services of the Elderly  

ERIC Educational Resources Information Center

We examine the effect of gaining prescription drug insurance, as a result of Medicare Part D, on use of prescription drugs and other medical services for a nationally representative sample of Medicare beneficiaries. Given the heightened importance of prescription drugs for those with chronic illness, we provide separate estimates for elderly in…

Kaestner, Robert; Nasreen Khan,

2012-01-01

391

Medicare Part D and Its Effect on the Use of Prescription Drugs and Use of Other Health Care Services of the Elderly  

ERIC Educational Resources Information Center

|We examine the effect of gaining prescription drug insurance, as a result of Medicare Part D, on use of prescription drugs and other medical services for a nationally representative sample of Medicare beneficiaries. Given the heightened importance of prescription drugs for those with chronic illness, we provide separate estimates for elderly in…

Kaestner, Robert; Nasreen Khan,

2012-01-01

392

What Matters Most? Assessing the Influence of Demographic Characteristics, College-Specific Risk Factors, and Poly-drug Use on Nonmedical Prescription Drug Use  

Microsoft Academic Search

Objective: Although prior recent research has revealed a significant relationship between the nonmedical use of prescription drugs, demographic characteristics, college-specific risk factors, and other substance use among college students, there remains a need to conduct a comparative analysis on the differential impact these factors may have on predicting nonmedical prescription drug use. Participants and Methods: In 2008 a convenience sample

Christina Lanier; Erin J. Farley

2011-01-01

393

Quantifying Age-Related Differences in Information Processing Behaviors When Viewing Prescription Drug Labels  

PubMed Central

Adverse drug events (ADEs) are a significant problem in health care. While effective warnings have the potential to reduce the prevalence of ADEs, little is known about how patients access and use prescription labeling. We investigated the effectiveness of prescription warning labels (PWLs, small, colorful stickers applied at the pharmacy) in conveying warning information to two groups of patients (young adults and those 50+). We evaluated the early stages of information processing by tracking eye movements while participants interacted with prescription vials that had PWLs affixed to them. We later tested participants’ recognition memory for the PWLs. During viewing, participants often failed to attend to the PWLs; this effect was more pronounced for older than younger participants. Older participants also performed worse on the subsequent memory test. However, when memory performance was conditionalized on whether or not the participant had fixated the PWL, these age-related differences in memory were no longer significant, suggesting that the difference in memory performance between groups was attributable to differences in attention rather than differences in memory encoding or recall. This is important because older adults are recognized to be at greater risk for ADEs. These data provide a compelling case that understanding consumers’ attentive behavior is crucial to developing an effective labeling standard for prescription drugs.

Sundar, Raghav Prashant; Becker, Mark W.; Bello, Nora M.; Bix, Laura

2012-01-01

394

Nonsocial Reinforcement of the Nonmedical Use of Prescription Drugs: A Partial Test of Social Learning and Self-Control Theories  

Microsoft Academic Search

In this study, we examine the explanation of the nonmedical use of prescription drugs. We test the comparative utility of two theories of drug use (i.e., social learning theory and self-control theory) on the nonmedical use of prescription drug use. Our contribution to social learning theory is the use of an understudied part of the theory—nonsocial reinforcement. We expect the

George E. Higgins; Margaret Mahoney; Melissa L. Ricketts

2009-01-01

395

Cocaine and opiate-related fatal overdose in New York City, 1990–2000  

Microsoft Academic Search

BACKGROUND: In New York City (NYC), the annual mortality rate is higher for accidental drug overdoses than for homicides; cocaine and opiates are the drugs most frequently associated with drug overdose deaths. We assessed trends and correlates of cocaine- and opiate-related overdose deaths in NYC during 1990–2000. METHODS: Data were collected from the NYC Office of the Chief Medical Examiner

Kyle T Bernstein; Angela Bucciarelli; Tinka Markham Piper; Charles Gross; Ken Tardiff; Sandro Galea

2007-01-01

396

College on Problems of Drug Dependence taskforce on prescription opioid non-medical use and abuse: position statement  

Microsoft Academic Search

This position paper from the College on Problems of Drug Dependence addresses the issues related to non-medical use and abuse of prescription opioids. A central theme throughout is the need to strike a balance between risk management strategies to prevent and deter prescription opioid abuse and the need for physicians and patients to have appropriate access to opioid pharmaceuticals for

James Zacny; George Bigelow; Peggy Compton; Kathleen Foley; Martin Iguchi; Christine Sannerud

2003-01-01

397

Circumstances and witness characteristics associated with overdose fatality  

PubMed Central

Objective Emergency physicians have an opportunity to provide overdose fatality prevention interventions to individuals at risk for experiencing or witnessing an overdose to reduce fatality. The present study uses data about the most recent overdose observed by a sample of inner-city drug users to determine the circumstances of overdose that are associated with overdose fatality. Methods Participants (n = 690), age 18+, were recruited using targeted street outreach. All participants had used heroin and/or cocaine in the prior 2 months, and had witnessed at least one overdose. Survey data included the circumstances of the last overdose witnessed, including actions taken, drug use behavior, the location of the event, and whether or not the overdose was fatal (the outcome measure). Results 152 (21.7%) of the witnessed overdoses were fatal. Witness powder cocaine use (Adjusted Odds Ratio [AOR] = 1.64, 95% Confidence Interval [CI] 1.03–2.60) and injection drug history (AOR = 0.55, 95% CI 0.32–0.90) were associated with the last witnessed overdose being fatal. Witnessed overdoses that occurred in public or abandoned buildings, compared to homes, were more likely to be fatal (AOR = 1.90, 95% CI 1.03–3.02), as were overdoses where witnesses sought outside medical help (AOR = 1.46, 95% CI 1.01–2.13). Conclusions Future prevention interventions may fruitfully target users of powder cocaine, drug users without a history of injecting, and individuals who use drugs in public or abandoned buildings for brief interventions on responding when witnessing an overdose to reduce mortality.

Bohnert, Amy S.B.; Tracy, Melissa; Galea, Sandro

2009-01-01

398

76 FR 1174 - Drugs for Human Use; Drug Efficacy Study Implementation; Oral Prescription Drugs Offered for...  

Federal Register 2010, 2011, 2012, 2013

...Relief of Symptoms of Cough, Cold, or Allergy; Withdrawal of Hearing Requests; Opportunity...drugs offered for relief of cough, cold, allergy, and related symptoms. The exemptions...Relief of Symptoms of Cough, Cold, or Allergy A. DESI Cough, Cold, or Allergy...

2011-01-07

399

Hydromorphone overdose  

MedlinePLUS

... a type of morphine. Hydromorphone is an opioid narcotic, which means it is an extremely powerful drug ... Fluids through a vein (by IV) Laxative Medicine (narcotic antagonist) to reverse the effect of the hydromorphone ...

400

78 FR 26374 - An Evaluation of the Prescription Drug User Fee Act Workload Adjuster; Request for Comments  

Federal Register 2010, 2011, 2012, 2013

...the Prescription Drug User Fee Act (PDUFA...reauthorized by the Food and Drug Administration Safety and Innovation Act...complexity in the human drug review program and...After review of the report and receipt of public...HFA- 305), Food and Drug...

2013-05-06

401

21 CFR 201.57 - Specific requirements on content and format of labeling for human prescription drugs.  

Code of Federal Regulations, 2010 CFR

21 Food and Drugs 4 2006-04-01 2006-04-01 false Specific...on content and format of labeling for human prescription drugs. 201.57 Section 201.57 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF...

2006-04-01

402

21 CFR 201.56 - Requirements on content and format of labeling for human prescription drug and biological products.  

Code of Federal Regulations, 2013 CFR

21 Food and Drugs 4 2013-04-01 2013-04-01 false...content and format of labeling for human prescription drug and biological products. 201.56 Section 201.56 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT...

2013-04-01

403

Media credibility and informativeness of direct-to-consumer prescription drug advertising.  

PubMed

In this article, we report the results of a study conducted to determine consumer perceptions of the media credibility and informativeness of direct-to-consumer prescription drug advertising (DTC advertising) and to examine how those perceptions are influenced by consumer predispositions and demographic characteristics, especially consumer age. This study specifically surveyed older consumers, who are the most significant market segment for prescription drugs and particularly susceptible and vulnerable to commercial persuasion. Older consumers' perceptions of DTC advertising were found to be neutral but their evaluation of informativeness was found to be more positive. Attitude toward DTC advertising and DTC advertising familiarity predicted perceived credibility across various media and attitude toward DTC advertising was the most prominent predictor of perceived informativeness. Age and usage of different media were also found to predict credibility and informativeness of DTC advertising in certain types of media. This study's findings provide insight into how older consumers evaluate various DTC advertising media as an information source. PMID:15739826

Huh, Jisu; DeLorme, Denise E; Reid, Leonard N

2004-01-01

404

What kind of patients and physicians value direct-to-consumer advertising of prescription drugs  

Microsoft Academic Search

Direct-to-consumer (DTC) advertising of prescription drugs can enhance the physician–patient relationship, as well as benefiting\\u000a its sponsor. However, overall benefits can only occur if the patients value the information enough to discuss it with their\\u000a physicians and the physicians are not predisposed against the DTC information. We investigate the impact of demographics and\\u000a exposure to marketing on consumers' and physicians'

Füsun F. Gönül; Franklin Carter; Jerry Wind

2000-01-01

405

Subjective Health Literacy and Older Adults' Assessment of Direct-to-Consumer Prescription Drug Ads  

Microsoft Academic Search

Older adults are increasingly the intended target of direct-to-consumer (DTC) prescription drug ads, but limited evidence exists as to how they assess the educational value of DTC ads and, more importantly, whether their assessment depends on their level of health literacy. In-person interviews of 170 older adults revealed that those with low subjective health literacy evaluated the educational value of

Soontae An; Nancy Muturi

2011-01-01

406

Textual Cues in Direct-to-Consumer Prescription Drug Advertising: Motivators to Communicate with Physicians  

Microsoft Academic Search

Growth of direct-to-consumer advertising (DTCA) of prescription drugs heightens concerns about its effects on the patient–physician relationship. Based on social cognitive theory, this study examines textual features of DTCA that may motivate patients to alter communication with physicians. Results of analyses of 225 unique advertisements found in 18 consumer magazines indicate that DTCA's textual messages associate instrumental and identity motivators

Henry N. Young; Rebecca J. Welch Cline

2005-01-01

407

Consumer choices between Over-The-Counter and prescription drugs: The case of Claritin  

Microsoft Academic Search

In recent years, a lively debate has taken place on the effects of switching drugs from prescription (Rx) to the Over-The-Counter (OTC) status. There is no doubt that the Rx-to-OTC switch affects the interests of various groups differently and there are different opinions about costs and benefits of the switch. The switch of Claritin to the OTC status triggered a

Anna A Ejakova

2008-01-01

408

Impact of Celebrity Pitch in Direct-to-Consumer Advertising of Prescription Drugs  

Microsoft Academic Search

Online surveys were conducted to determine the impact of endorser credibility, endorser effectiveness, and consumers’ involvement in direct-to-consumer advertising. In a randomized posttest only study, using the elaboration likelihood model, survey participants (U.S. adults) were either exposed to a fictitious prescription drug ad with a celebrity or a noncelebrity endorser. There was no significant difference in credibility and effectiveness between

Nilesh S. Bhutada; Ajit M. Menon; Aparna D. Deshpande; Matthew Perri III

2012-01-01

409

“Others are influenced, but not me”: Older adults' perceptions of DTC prescription drug advertising effects  

Microsoft Academic Search

A series of in-depth interviews was conducted to examine older adults' perceptions of the effects of direct-to-consumer (DTC) prescription drug advertising on themselves and others. Results give empirical voice to published survey findings and provide additional evidence to support the third-person effect in DTC advertising. Findings indicate that older adults do not perceive DTC ad effects on themselves when asked

Denise E. DeLorme; Jisu Huh; Leonard N. Reid

2007-01-01

410

A Content Analysis of Direct-to-Consumer Television Prescription Drug Advertisements  

Microsoft Academic Search

This article reports the results of a content analysis of 23 direct-to-consumer (DTC) product-specific television prescription drug advertisements broadcast during 2001. A majority of ads used both medical and lay terms to convey medical ideas. Most gave consumers somewhat more time to absorb facts about benefits than those about risks, which could have implications for the “fair balance” requirement. Complete

KIMBERLY A. KAPHINGST; WILLIAM DEJONG; RIMA E. RUDD; LAWREN H. DALTROY

2004-01-01

411

Evaluation, Use, and Usefulness of Prescription Drug Information Sources Among Anglo and Hispanic Americans  

Microsoft Academic Search

This survey was conducted to determine and compare how Anglo and Hispanic Americans evaluate and use interpersonal, advertising, and mediated sources of prescription drug information. Findings suggest the following: (1) Hispanics rely on doctors, Internet advertising sources, and direct-to-consumer advertising (DTCA), while Anglos frequently use health-related websites and health care professionals; (2) Anglos are more likely to use health-related websites

Denise E. DeLorme; Jisu Huh; Leonard N. Reid

2010-01-01

412

Seniors' Uncertainty Management of Direct-to-Consumer Prescription Drug Advertising Usefulness  

Microsoft Academic Search

This study provides insight into seniors' perceptions of and responses to direct-to-consumer prescription drug advertising (DTCA) usefulness, examines support for DTCA regulation as a type of uncertainty management, and extends and gives empirical voice to previous survey results through methodological triangulation. In-depth interview findings revealed that, for most informants, DTCA usefulness was uncertain and this uncertainty stemmed from 4 sources.

Denise E. DeLorme; Jisu Huh

2009-01-01

413

The past, present, and future of direct-to-consumer prescription drug advertising  

Microsoft Academic Search

Since the first experiences with direct-toconsumer c(DTC) prescription drug advertising in the early 1980s, pharmaceutical marketers, government regulators, researchers, health practitioners, and consumers have been both perplexed and intrigued by this practice. As experience with DTC advertising has expanded, so has knowledge and understanding of its risks and rewards. This article discusses important issues in DTC advertising, such as the

Matthew Perri; Shashank Shinde; Reshma Banavali

1999-01-01

414

A syringe prescription program to prevent infectious disease and improve health of injection drug users  

Microsoft Academic Search

Injection drug users (IDUs) are at increased risk for many health problems, including acquisition of human immunodeficiency\\u000a virus (HIV) and hepatitis B and C. These risks are compounded by barriers in obtaining legal, sterile syringes and in accessing\\u000a necessary medical care. In 1999, we established the first-ever syringe prescription program in Providence, Rhode Island, to\\u000a provide legal access to sterile

Josiah D. Rich; Michelle McKenzie; Grace E. Macalino; Lynn E. Taylor; Stephanie Sanford-Colby; Francis Wolf; Susan McNamara; Meenasshi Mehrotra; Michael D. Stein

2004-01-01

415

Paediatric drug use with focus on off-label prescriptions in Swedish outpatient care - a nationwide study  

PubMed Central

Aim To determine drug prescription and proportion of off-label dispensing in the Swedish paediatric outpatient population. Methods All dispensed outpatient prescriptions to children aged 0 < 18 years as well as the proportion of off-label drug use during 2007 were analysed using data from the Swedish Prescribed Drug Register. Results In total, 2.19 million drug prescriptions of 898 different drug substances were dispensed to paediatric patients, and of those substances, 64% had been dispensed off-label at least once. The overall off-label rate of all prescriptions was 13.5%, among which topical drugs as well as sex hormones were the most commonly prescribed off-label drugs. More than half of all children in Sweden had received at least one prescribed drug in 2007. Conclusions There is a high prescribing of medicines to children in outpatient care in Sweden with a considerable amount of off-label prescriptions. Topically administered drugs, sex hormones, antidepressants, hypnotics, cardiovascular drugs and nonsteroidal anti-inflammatory drugs were commonly prescribed off-label.

Olsson, J; Kimland, E; Pettersson, S; Odlind, V

2011-01-01

416

Use of Instrumental Variable in Prescription Drug Research with Observational Data: A Systematic Review  

PubMed Central

Objective Instrumental variable (IV) analysis may offer a useful approach to the problem of unmeasured confounding in prescription drug research if the IV is: 1) strongly and unbiasedly associated to treatment assignment; and 2) uncorrelated with factors predicting the outcome (key assumptions). Study Design and Methods We conducted a systematic review of the use of IV methods in prescription drug research to identify the major types of IVs and the evidence for meeting IV assumptions. We searched MEDLINE, OVID, PsychoInfo, Econlit and economic databases from 1961 to 2009. Results We identified 26 studies. Most (n=16) were published after 2007. We identified five types of IVs: regional variation (n=8), facility prescribing patterns (n=5), physician preference (n=8), patient history/financial status (n=3) and calendar time (n=4). Evidence supporting the validity of IV was inconsistent. All studies addressed the first IV assumption; however, there was no standard for demonstrating that the IV sufficiently predicted treatment assignment. For the second assumption, 23 studies provided explicit argument that IV was uncorrelated with the outcome, and 16 supported argument with empirical evidence. Conclusions Use of IV methods is increasing in prescription drug research. However, we did not find evidence of a dominant IV. Future research should develop standards for reporting the validity and strength of IV according to key assumptions.

Chen, Yong; Briesacher, Becky A.

2010-01-01

417

Financial Disparities In Prescription Drug Use Between Elderly And Nonelderly Americans Elderly people bear a disproportionately high out-of-pocket spending burden for prescription drugs, even at higher income levels  

Microsoft Academic Search

This study examines cross-sectional disparities in the financial burden of pre- scription drug use among U.S. elderly and nonelderly adult populations, using data from the 1998 Medical Expenditure Panel Survey. Out-of-pocket spending for prescriptions, copayment rates, and the proportion of family income spent on prescription drugs were ex- amined to compare elderly people with working-age adults. Even after utilization or

K. Tom Xu

418

Pharmaceutical pricing: a review of proposals to improve access and affordability of prescription drugs.  

PubMed

This article discusses how pharmaceutical innovation achieves remarkable improvements in human health but a significant portion of the U.S. population cannot afford prescription drugs. The author examines ways that patent protection, generics, supply chain complexity, and the cost of innovation and promotion affect access and affordability. The author then looks at the influences of marketing strategies and industry trends such as the patent cliff and pipeline for new drugs, innovations in biotechnology and genomics, comparative effectiveness analysis, and payor and employer strategies on drug prices. An analysis of reform proposals in the context of industry trends suggests that promoting generic drug use and availability through education, prohibiting authorized generics, and restricting the practice of developing follow-on drugs and discontinuing the original formulations upon patent expiration could improve access and affordability most quickly and significantly. PMID:21443147

Tironi, Paula

2010-01-01

419

Literacy demands of product information intended to supplement television direct-to-consumer prescription drug advertisements.  

PubMed

The US Food and Drug Administration (FDA) allows television direct-to-consumer (DTC) prescription drug advertisements that do not fully disclose drug risks if the ads include "adequate provision" for dissemination of the drug's approved labeling. This requirement can be met in part by referring consumers to multiple text sources of product labeling. This study was designed to assess the materials to which consumers were referred in 23 DTC television advertisements. SMOG assessments showed that the average reading grade levels were in the high school range for the main body sections of the materials and college-level range for the brief summary sections. The Suitability Assessment of Materials (SAM) instrument identified specific difficulties with the materials, including content, graphics, layout, and typography features. Stronger plain language requirements are recommended. Health care providers should be aware that patients who ask about an advertised drug might not have the full information required to make an informed decision. PMID:15530767

Kaphingst, Kimberly A; Rudd, Rima E; DeJong, William; Daltroy, Lawren H

2004-11-01

420

20 CFR 418.1322 - How will a Medicare prescription drug coverage income-related monthly adjustment amount...  

Code of Federal Regulations, 2013 CFR

... 2013-04-01 false How will a Medicare prescription drug coverage income-related...determination for the effective year affect your Medicare Part B? 418.1322 Section 418...Benefits SOCIAL SECURITY ADMINISTRATION MEDICARE SUBSIDIES Medicare Part B...

2013-04-01

421

Prescription Drug Data: HHS Has Issued Health Privacy and Security Regulations but Needs to Improve Guidance and Oversight.  

National Technical Information Service (NTIS)

While the Department of Health and Human Services (HHS) has established a framework for protecting the privacy and security of Medicare beneficiaries prescription drug use information when used for purposes other than direct clinical care through its issu...

2012-01-01

422

Multifaceted determinants of online non-prescription drug information seeking and the impact on consumers' use of purchase channels.  

PubMed

The growing importance of the Internet as an information and purchasing channel is drawing widespread attention from marketing decision makers. Nevertheless, the relevance of the Internet to the so-called self-medication market in Germany has been paid barely enough attention. Our study aims to contribute insights concerning the penetration of the Internet in this market, as well as to give an overview of the critical determinants of Internet use for non-prescription drug information seeking, such as the accessibility of professional information, trust in health professionals' opinion and the ability to search online, as well as the perceived usefulness and credibility of online non-prescription drug information. Furthermore, we demonstrate that the preferred use of the Internet as a non-prescription drug information source positively influences the choice of unconventional purchase channels for non-prescription drugs and negatively affects the use of stationary pharmacies. PMID:22733678

Holtgräfe, Catherine; Zentes, Joachim

2012-06-01

423

Prescription of anti-osteoporosis drugs during 2004–2007—a nationwide register study in Norway  

Microsoft Academic Search

Purpose  To assess 1-year prevalence, incidence rates and minimum refill of anti-osteoporosis drug use in Norway by age, gender and\\u000a place of residence during 2004–2007.\\u000a \\u000a \\u000a \\u000a Methods  Data from patients aged ? 40 years receiving anti-osteoporosis drugs (AOD) were retrieved from the Norwegian Prescription\\u000a Database (NorPD). AOD were defined as bisphosphonates (alendronate with or without cholecalciferol, risedronate, ibandronate\\u000a and etidronate with or without calcium),

Helene M. Devold; Gia Man Doung; Aage Tverdal; Kari Furu; Haakon E. Meyer; Jan A. Falch; Anne Johanne Sogaard

2010-01-01

424

Impact of celebrity pitch in direct-to-consumer advertising of prescription drugs.  

PubMed

Online surveys were conducted to determine the impact of endorser credibility, endorser effectiveness, and consumers' involvement in direct-to-consumer advertising. In a randomized posttest only study, using the elaboration likelihood model, survey participants (U.S. adults) were either exposed to a fictitious prescription drug ad with a celebrity or a noncelebrity endorser. There was no significant difference in credibility and effectiveness between the celebrity and the noncelebrity endorser. High involvement consumers viewed the ad more favorably and exhibited significantly stronger drug inquiry intentions during their next doctor visit. Further, consumers' involvement did not moderate the effect of celebrity endorser. PMID:22416924

Bhutada, Nilesh S; Menon, Ajit M; Deshpande, Aparna D; Perri, Matthew

2012-01-01

425

Prescription of drugs during pregnancy: a study using EFEMERIS, the new French database  

Microsoft Academic Search

Background  Because of the limited data concerning drug risks in pregnancy, health professionals are often deprived of relevant and sufficient\\u000a information related to prescribing or dispensing during pregnancy. However, previous studies have emphasised the widespread\\u000a French prescription of several drugs (sometimes “typically French”) which have not been assessed in pregnant women.\\u000a \\u000a \\u000a \\u000a Objectives  The aim of the present study was to create the

I. Lacroix; C. Hurault; M. F. Sarramon; C. Guitard; A. Berrebi; M. Grau; C. Albouy-Cossard; R. Bourrel; E. Elefant; J. L. Montastruc; C. Damase-Michel

2009-01-01

426

Teens and the Misuse of Prescription Drugs: Evidence-Based Recommendations to Curb a Growing Societal Problem  

Microsoft Academic Search

The misuse of prescription drugs by teens in the United States is a growing public health problem. This article provides a\\u000a systematic synthesis of multiple strands of literature to recommend effective prevention methods. Using a social-ecological\\u000a framework, we review the scope of the problem of prescription drug use among teens. Then, we analyze the multiple factors\\u000a that may influence teen

Eric C. Twombly; Kristen D. Holtz

2008-01-01

427

Direct-to-consumer advertising of prescription drugs: European Commission persists in putting industry's interests first.  

PubMed

In late September 2010, Members of the European Parliament (MEPs) issued their verdict on European Commission proposals aimed at lifting the ban on pharmaceutical companies communicating directly with the general public about prescription drugs. The MEPs were able to limit the scope of some of the more harmful aspects of these proposals, in particular by proposing that drug regulatory agencies should pre-screen the "information" produced by drug companies before it is made available to the public. In December 2010, faced with ongoing opposition from European Member States, the Commission appeared to back down, announcing that it was drawing up "amended proposals". They were publicly released in February 2012 but still leave the door open to direct-to-consumer advertising of prescription drugs, particularly "reminder advertising". As of 4 July 2012, the amended proposals had not yet been examined by Member States, thus obstructing the legislative process. Public health and management of the costs of social services for Member States are at stake. The Medicines in Europe Forum (MiEF) and the International Society of Drug Bulletins (ISDB) urge Member States to continue to refuse to examine the Commission's proposals, and have drawn up concrete counterproposals that would enable the general public to obtain relevant health information. PMID:23373084

2013-01-01

428

Exposure to potential CYP450 pharmacokinetic drug-drug interactions among osteoarthritis patients: incremental risk of multiple prescriptions.  

PubMed

Patients taking more than one drug metabolized through the cytochrome P450 (CYP450) enzyme system experience a drug-drug exposure (DDE), which puts them at risk for a potential pharmacokinetic drug-drug interaction (DDI), defined as two or more drugs interacting in such a way that the effectiveness and/or toxicity of one or all drugs are changed. Any patient subjected to a DDE is at risk for a potentially serious DDI, the epidemiology of which has not been thoroughly studied. Many drugs are metabolized primarily via the CYP450 enzyme system, including certain opioids used to manage moderate to severe chronic pain. We conducted a retrospective analysis of a large commercial claims database and a Medicare database to assess the prevalence of DDEs among patients with osteoarthritis taking CYP450-metabolized opioids. The overall prevalence of DDEs in this population was 26%, with females more likely to experience DDEs than males (28.4% vs. 21.0%, respectively). The number of unique concurrent prescriptions at baseline, gender, age, and Charlson Comorbidity Index were statistically significant predictors of DDEs (P?prescriptions the patient received in the 90-day window prior to the index date was a risk factor. For patients taking at least two medications in the 90-day period prior to the index date, every additional prescription taken increased their risk for a DDE during the observation period by 138% (on average). The risk of DDE during the study period was threefold greater for patients with one medication in the 90-day period before index date compared with similar patients with no prescriptions in that same period before the index date. DDEs are more common than may be generally believed in patients with osteoarthritis, regardless of age, and can occur even in patients taking few medications. When selecting an opioid analgesic to treat osteoarthritis, physicians should consider the potential for exposure of these patients to drugs that could interact unfavorably.? PMID:21199317

Pergolizzi, Joseph V; Labhsetwar, Sumedha A; Puenpatom, R Amy; Joo, Seongjung; Ben-Joseph, Rami; Summers, Kent H

2010-12-28

429

Prevalence and predictors of non-medical prescription drug use among men who have sex with men.  

PubMed

Although non-medical prescription drug use has dramatically increased in many populations during the past decade, this phenomenon remains understudied among men who have sex with men (MSM). Using a community-based sample of MSM, we provide data on the high prevalence of lifetime and recent non-medical prescription drug use among MSM for a range of prescription drug classes such as pain killers, sedatives, sleep aids, stimulants, and erectile dysfunction medications. The paper also highlights differences in rates of recent non-medical prescription drug use within this population, noting that White MSM, HIV-positive MSM, gay-identified MSM, and MSM over 40 were typically more likely to have recently used a range of prescription drugs than their counterparts. After controlling for various factors, the findings demonstrate that age, HIV-positive status, gay identity, low educational level, and White race are significant correlates of both lifetime and recent non-medical prescription drug use among MSM. The data suggest that prevention and treatment efforts for this population are likely to require some tailoring, particularly for HIV-positive MSM who may have different needs than other MSM given their health concerns and medication regimens. PMID:19944538

Kelly, Brian C; Parsons, Jeffrey T

2009-11-11

430

'He was like a zombie': off-label prescription of antipsychotic drugs in dementia.  

PubMed

This paper explores the legal position of the off-label prescription of antipsychotic medications to people with dementia who experience behavioural and psychological symptoms of dementia (BPSD). Dementia is a challenging illness, and BPSD can be very difficult for carers to manage, with evidence that this contributes to carer strain and can result in the early institutionalisation of people with dementia. As a result, the prescription of antipsychotic and other neuroleptic medications to treat BPSD has become commonplace, in spite of these drugs being untested and unlicensed for use to treat older people with dementia. In recent years, it has become apparent through clinical trials that antipsychotic drugs increase the risk of cerebrovascular accident (stroke) and death in people with dementia. In addition, these types of medication also have other risk factors for people with dementia, including over-sedation and worsening of cognitive function. Drawing on recent questionnaire (n = 185), focus group (n = 15), and interview (n = 11) data with carers of people with dementia, this paper explores the law relating to off-label prescription, and the applicability of medical negligence law to cases where adverse events follow the use of antipsychotic medication. It is argued that the practice of off-label prescribing requires regulatory intervention in order to protect vulnerable patients. PMID:23047844

Harding, Rosie; Peel, Elizabeth

2012-10-09

431

When drugs in the same controlled substance schedule differ in real-world abuse, should they be differentiated in labeling?  

Microsoft Academic Search

The prescription drugs regulated in the most restrictive controlled substance schedule for those with an approved therapeutic use vary widely in their real world risk of abuse and harm. Opioid analgesics have the highest rates of abuse, overdose death, drug abuse treatment needs and societal costs in comparison to other Schedule II drugs. Stimulants for attention-deficit\\/hyperactivity disorders (ADHD) account for

Nabarun Dasgupta; Jack E. Henningfield; Michelle D. Ertischek; Sidney H. Schnoll

2011-01-01

432

Adequacy of FDA'S Prescription to over-the-Counter Switch Criteria in Physician Evaluation of Proposed Switches of Drug Products  

Microsoft Academic Search

Futurists have forecast that, by the turn of the century, a majority of today's prescription drugs will be switched to over-the-counter (OTC) status. Currently, the Food and Drug Administration (FDA) evaluates potential switch candidates primarily using safety, effectiveness, and labeling criteria. These criteria may not be adequate because of the reported mishaps associated with OTC drug use. The criteria implicitly

Suresh Madhavan

1994-01-01

433

The Effects of Print Format in Direct-to-Consumer Prescription Drug Advertisements on Risk Knowledge and Preference  

Microsoft Academic Search

This research examined the effects of format in print direct-to-consumer (DTC) prescription drug advertisements in communicating benefit and risks. Print advertisements for six fictitious drugs were created. Each drug was manipulated on the basis of six conditions, differing on the basis of color and the integration or separation of the benefit and risk information. A sixth condition (control) lacked risk

Michael S. Wogalter; Tonya L. Smith-Jackson; Brian J. Mills; Corrina S. Paine

2002-01-01

434

21 CFR 201.80 - Specific requirements on content and format of labeling for human prescription drug and...  

Code of Federal Regulations, 2010 CFR

21 Food and Drugs 4 2007-04-01 2007-04-01 false Specific...requirements on content and format of labeling for human prescription drug and biological products; older drugs not described in ç 201.56(b)(1). 201.80...

2007-04-01

435

21 CFR 201.80 - Specific requirements on content and format of labeling for human prescription drug and...  

Code of Federal Regulations, 2010 CFR

21 Food and Drugs 4 2008-04-01 2008-04-01 false Specific...requirements on content and format of labeling for human prescription drug and biological products; older drugs not described in ç 201.56(b)(1). 201.80...

2008-04-01

436

Impact of training for healthcare professionals on how to manage an opioid overdose with naloxone: Effective, but dissemination is challenging  

Microsoft Academic Search

BackgroundOpioid overdose has a high mortality, but is often reversible with appropriate overdose management and naloxone (opioid antagonist). Training in these skills has been successfully trialled internationally with opioid users themselves. Healthcare professionals working in substance misuse are in a prime position to deliver overdose prevention training to drug users and may themselves witness opioid overdoses. The best method of

Soraya Mayet; Victoria Manning; Anna Williams; Jessica Loaring; John Strang

2011-01-01

437

Social and structural aspects of the overdose risk environment in St. Petersburg, Russia  

PubMed Central

Background While overdose is a common cause of mortality among opioid injectors worldwide, little information exists on opioid overdoses or how context may influence overdose risk in Russia. This study sought to uncover social and structural aspects contributing to fatal overdose risk in St. Petersburg and assess prevention intervention feasibility. Methods Twenty-one key informant interviews were conducted with drug users, treatment providers, toxicologists, police, and ambulance staff. Thematic coding of interview content was conducted to elucidate elements of the overdose risk environment. Results Several factors within St. Petersburg’s environment were identified as shaping illicit drug users’ risk behaviors and contributing to conditions of suboptimal response to overdose in the community. Most drug users live and experience overdoses at home, where family and home environment may mediate or moderate risk behaviors. The overdose risk environment is also worsened by inefficient emergency response infrastructure, insufficient cardiopulmonary or naloxone training resources, and the preponderance of abstinence-based treatment approaches to the exclusion of other treatment modalities. However, attitudes of drug users and law enforcement officials generally support overdose prevention intervention feasibility. Modifiable aspects of the risk environment suggest community-based and structural interventions, including overdose response training for drug users and professionals that encompasses naloxone distribution to the users and equipping more ambulances with naloxone. Conclusion Local social and structural elements influence risk environments for overdose. Interventions at the community and structural levels to prevent and respond to opioid overdoses are needed for and integral to reducing overdose mortality in St. Petersburg.

Grau, Lauretta E.; Blinnikova, Ksenia N.; Torban, Mikhail; Krupitsky, Evgeny; Ilyuk, Ruslan; Kozlov, Andrei; Heimer, Robert

2009-01-01

438

Association between unemployment rates and prescription drug utilization in the United States, 2007-2010  

PubMed Central

Background While extensive evidence suggests that the economic recession has had far reaching effects on many economic sectors, little is known regarding its impact on prescription drug utilization. The purpose of this study is to describe the association between state-level unemployment rates and retail sales of seven therapeutic classes (statins, antidepressants, antipsychotics, angiotensin-converting enzyme [ACE] inhibitors, opiates, phosphodiesterase [PDE] inhibitors and oral contraceptives) in the United States. Methods Using a retrospective mixed ecological design, we examined retail prescription sales using IMS Health Xponent™ from September 2007 through July 2010, and we used the Bureau of Labor Statistics to derive population-based rates and mixed-effects modeling with state-level controls to examine the association between unemployment and utilization. Our main outcome measure was state-level utilization per 100,000 people for each class. Results Monthly unemployment levels and rates of use of each class varied substantially across the states. There were no statistically significant associations between use of ACE inhibitors or SSRIs/SNRIs and average unemployment in analyses across states, while for opioids and PDE inhibitors there were small statistically significant direct associations, and for the remaining classes inverse associations. Analyses using each state as its own control collectively exhibited statistically significant positive associations between increases in unemployment and prescription drug utilization for five of seven areas examined. This relationship was greatest for statins (on average, a 4% increase in utilization per 1% increased unemployment) and PDE inhibitors (3% increase in utilization per 1% increased unemployment), and lower for oral contraceptives and atypical antipsychotics. Conclusion We found no evidence of an association between increasing unemployment and decreasing prescription utilization, suggesting that any effects of the recent economic recession have been mitigated by other market forces.

2012-01-01

439

Prescription Opioid Use, Misuse, and Diversion among Street Drug Users in New York City  

PubMed Central

Objective The use of heroin, cocaine, and other drugs is well researched in New York City, but prescription opioids (POs) have been overlooked. This study documents patterns of PO use, misuse, and diversion among street drug users, and begins to indicate how drug culture practices interact with the legitimate therapeutic goals of PO prescriptions (e.g. pain management). Methods Staff completed interviews inquiring about the reasons for use of POs and illicit drugs with 586 street drug users. Ethnographers wrote extensive field notes about subjects’ complex patterns of PO use. Results Methadone was used (71.9%) and sold (64.7%) at a higher level than OxyContin, Vicodin, and Percocet, used by between 34% and 38% of the users and sold by between 28% and 41% of the sellers. Recent PO use is associated with the recency of using heroin and cocaine (p<.001). Half of the heroin/cocaine sellers sold POs, and one quarter of the PO sellers only sold POs. Subjects were classified into four groups by whether they diverted POs or used POs to relieve pain or withdrawal rather than for euphoria. This classification was associated with frequency of PO use, whether POs were obtained from doctors/pharmacies or from drug dealers and family members, and those mostly likely to use POs for pain and withdrawal. Conclusions POs are an important component of street drug users’ drug-taking regimes, especially those who are Physically III Chemical Abusers (PICA). Future research is needed to model PO use, misuse, and diversion among this population.

Rees Davis, W.; Johnson, Bruce D.

2008-01-01

440

Physicians' decision process for drug prescription and the impact of pharmaceutical marketing mix instruments.  

PubMed

This paper provides an in-depth, qualitative analysis of the physicians' decision process for drug prescription. Drugs in the considered therapeutic classes are mainly prescribed by specialists, treating patients with obligatory medical insurance, for a prolonged period of time. The research approach is specifically designed to capture the full complexity and sensitive nature of the physician's choice behavior, which appears to be more hybrid and less rational in nature than is often assumed in quantitative, model-based analyses of prescription behavior. Several interesting findings emerge from the analysis: (i) non-compensatory decision rules seem to dominate the decision process, (ii) consideration sets are typically small and change-resistant, (iii) drug cost is not a major issue for most physicians, (iv) detailing remains one of the most powerful pharmaceutical marketing instruments and is highly appreciated as a valuable and quick source of information, and (v) certain types of non-medical marketing incentives (such as free conference participation) may in some situations also influence drug choices. PMID:16597584

Campo, Katia; De Staebel, Odette; Gijsbrechts, Els; van Waterschoot, Walter

2005-01-01

441

[Prescription to elderly patients: reducing underuse and adverse drug reactions and improving adherence].  

PubMed

Many elderly people take multiple medications, usually for multiple health disorders. This "polymedication" increases the risk of iatrogenic disorders, may affect adherence to treatment, and represents an economic burden for society. It is therefore essential to optimize drug prescription to the elderly. The general practitioner is most involved in treating the elderly, who tend not to consult specialists as frequently as younger adults do. Most elderly subjects with comorbidities and polymedication are excluded from clinical trials, and geriatrics is not considered a priority during medical training. Three suboptimal prescription modalities have been described in the elderly population : "overuse", "misuse", and "underuse". Adverse drug reactions are frequent in the elderly and have a major economic cost. They are behind about 10 % of hospital admissions over the age of 65, and 20 % over 80. Yet most advers drug reactions are preventable. The public health consequences of non adherence to drug therapy are poorly documented. Elderly people may have several risk factors for non adherence, and a combination of measures may be necessary to improve the situation. PMID:17969547

Legrain, Sylvie

2007-02-01

442

Prediction and Prevention of Prescription Drug Abuse: Role of Preclinical Assessment of Substance Abuse Liability  

PubMed Central

In 2011, the prevalence of prescription drug abuse exceeded that of any other illicit drug except marijuana. Consequently, efforts to curtail abuse of new medications should begin during the drug development process, where abuse liability can be identified and addressed before a candidate medication has widespread use. The first step in this process is scheduling with the Drug Enforcement Agency so that legal access is appropriately restricted, dependent upon levels of abuse risk and medical benefit. To facilitate scheduling, the Food and Drug Administration (FDA) has published guidance for industry that describes assessment of abuse liability. The purpose of this paper is to review methods that may be used to satisfy the FDA’s regulatory requirements for animal behavioral and dependence pharmacology. Methods include psychomotor activity, self-administration (an animal model of the rewarding effects of a drug), drug discrimination (an animal model of the subjective effects of a drug), and evaluation of tolerance and dependence. Data from tests conducted at RTI with known drugs of abuse illustrate typical results, and demonstrate that RTI is capable of performing these tests. While using preclinical data to predict abuse liability is an imperfect process, it has substantial predictive validity. The ultimate goal is to increase consumer safety through appropriate scheduling of new medications.

Marusich, Julie A.; Lefever, Timothy W.; Novak, Scott P.; Blough, Bruce E.; Wiley, Jenny L.

2013-01-01

443

Trends in opiate overdose deaths in Australia 1979–1995  

Microsoft Academic Search

Aims: to determine if there had been an increase in the rate of opioid overdose deaths between 1979 and 1995, and to describe the characteristics of persons who died of an opioid overdose. Method: opioid overdose deaths were defined according to ICD-9 as deaths due to drug dependence (codes 304.0 and 304.7) and accidental opiate poisoning (code E850.0). Data were

Wayne Hall; Shane Darke

1998-01-01

444

Use of illicit and prescription drugs for cognitive or mood enhancement among surgeons  

PubMed Central

Background Surgeons are usually exposed to high workloads leading to fatigue and stress. This not only increases the likelihood of mistakes during surgery but also puts pressure on surgeons to use drugs to counteract fatigue, distress, concentration deficits, burnout or symptoms of depression. The prevalence of surgeons taking pharmacological cognitive enhancement (CE) or mood enhancement (ME) drugs has not been systematically assessed so far. Methods Surgeons who attended five international conferences in 2011 were surveyed with an anonymous self-report questionnaire (AQ) regarding the use of prescription or illicit drugs for CE and ME and factors associated with their use. The Randomized Response Technique (RRT) was used in addition. The RRT guarantees a high degree of anonymity and confidentiality when a person is asked about stigmatizing issues, such as drug abuse. Results A total of 3,306 questionnaires were distributed and 1,145 entered statistical analysis (response rate: 36.4%). According to the AQ, 8.9% of all surveyed surgeons confessed to having used a prescription or illicit drug exclusively for CE at least once during lifetime. As one would expect, the prevalence rate assessed by RRT was approximately 2.5-fold higher than that of the AQ (19.9%; 95% confidence interval (CI), 15.9% to 23.9%, N = 1,105). An even larger discrepancy between the RRT and AQ was observed for the use of antidepressants with a 6-fold higher prevalence (15.1%; 95% CI, 11.3% to 19.0%, N = 1,099) as compared to 2.4% with the AQ. Finally, logistic regression analysis revealed that pressure to perform at work (odds ratio (OR): 1.290; 95% CI, 1.000 to 1.666; P = 0.05) or in private life (OR: 1.266; 95% CI, 1.038 to 1.543; P = 0.02), and gross income (OR: 1.337; 95% CI, 1.091 to 1.640; P = 0.005), were positively associated with the use of drugs for CE or ME. Conclusions The use of illicit and prescription drugs for CE or ME is an underestimated phenomenon among surgeons which is generally attributable to high workload, perceived workload, and private stress. Such intake of drugs is associated with attempts to counteract fatigue and loss of concentration. However, drug use for CE may lead to addiction and to overestimation of one’s own capabilities, which can put patients at risk. Coping strategies should be taught during medical education.

2013-01-01

445

Managing Prescriptions  

MedlinePLUS

... all your prescriptions also helps avoid dangerous drug interactions. Expect to treat high blood pressure for life. ... About High Blood Pressure (HBP) • 2. Why HBP Matters • 3. Your Risk for HBP • 4. Symptoms, Diagnosis & ...

446

Potential drug-drug and drug-disease interactions in prescriptions for ambulatory patients over 50 years of age in family medicine clinics in Mexico City  

PubMed Central

Background In Mexico, inappropriate prescription of drugs with potential interactions causing serious risks to patient health has been little studied. Work in this area has focused mainly on hospitalized patients, with only specific drug combinations analyzed; moreover, the studies have not produced conclusive results. In the present study, we determined the frequency of potential drug-drug and drug-disease interactions in prescriptions for ambulatory patients over 50 years of age, who used Mexican Institute of Social Security (IMSS) family medicine clinics. In addition, we aimed to identify the associated factors for these interactions. Methods We collected information on general patient characteristics, medical histories, and medication (complete data). The study included 624 ambulatory patients over 50 years of age, with non-malignant pain syndrome, who made ambulatory visits to two IMSS family medicine clinics in Mexico City. The patients received 7-day prescriptions for non-opioid analgesics. The potential interactions were identified by using the Thompson Micromedex program. Data were analyzed using descriptive, bivariate and multiple logistic regression analyses. Results The average number of prescribed drugs was 5.9 ± 2.5. About 80.0% of patients had prescriptions implying one or more potential drug-drug interactions and 3.8% of patients were prescribed drug combinations with interactions that should be avoided. Also, 64.0% of patients had prescriptions implying one or more potential drug disease interactions. The factors significantly associated with having one or more potential interactions included: taking 5 or more medicines (adjusted Odds Ratio (OR): 4.34, 95%CI: 2.76–6.83), patient age 60 years or older (adjusted OR: 1.66, 95% CI: 1.01–2.74) and suffering from cardiovascular diseases (adjusted OR: 7.26, 95% CI: 4.61–11.44). Conclusion The high frequency of prescription of drugs with potential drug interactions showed in this study suggests that it is common practice in primary care level. To lower the frequency of potential interactions it could be necessary to make a careful selection of therapeutic alternatives, and in cases without other options, patients should be continuously monitored to identify adverse events.

Doubova (Dubova), Svetlana Vladislavovna; Reyes-Morales, Hortensia; Torres-Arreola, Laura del Pilar; Suarez-Ortega, Magdalena

2007-01-01

447

How Might the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 Affect the Financial Viability of Rural Pharmacies? An Analysis of Preimplementation Prescription Volume and Payment Sources in Rural and Urban Areas  

ERIC Educational Resources Information Center

Passage of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) has created interest in how the legislation will affect access to prescription drugs among rural beneficiaries. Policy attention has focused to a much lesser degree on the implications of the MMA for the financial viability of rural pharmacies. This article…

Fraher, Erin P.; Slifkin, Rebecca T.; Smith, Laura; Randolph, Randy; Rudolf, Matthew; Holmes, George M.

2005-01-01

448

Methyl salicylate overdose  

MedlinePLUS

Deep heating rubs overdose; Oil of wintergreen overdose ... Deep-heating creams (Ben Gay, Icy Hot) used to relieve sore muscles and joints Oil of wintergreen Solutions for vaporizers Note: This list may not include all products that contain methyl salicylate.

449

Korean Americans' prescription drug information seeking and evaluation and use of different information sources.  

PubMed

This study examined Korean Americans' prescription drug information seeking, evaluation and use of different information sources, and communication with physicians, and compared the findings with those from the White American population. The results suggest that although Korean and White Americans were similar in extent of drug information seeking, Korean Americans tended to experience relatively greater difficulty finding information. Regarding perceived source usefulness, Korean Americans were significantly more likely to perceive higher usefulness in mass media and direct-to-consumer advertising sources than were Whites. Korean Americans were also more likely to use fewer sources, and less likely to use mass media and printed materials in drug information seeking. However, the hypothesized in-group source preference by Korean Americans was not found. PMID:23472746

Huh, Jisu; Delorme, Denise E; Reid, Leonard N; Kim, Junga

2013-03-08

450

Potential Drug-Drug Interactions in Prescriptions to Patients over 45 Years of Age in Primary Care, Southern Brazil  

PubMed Central

Background Few cross-sectional studies involving adults and elderly patients with major DDIs have been conducted in the primary care setting. The study aimed to investigate the prevalence of potential drug-drug interactions (DDIs) in patients treated in primary care. Methodology/Principal Findings A cross-sectional study involving patients aged 45 years or older was conducted at 25 Basic Health Units in the city of Maringá (southern Brazil) from May to December 2010. The data were collected from prescriptions at the pharmacy of the health unit at the time of the delivery of medication to the patient. After delivery, the researcher checked the electronic medical records of the patient. A total of 827 patients were investigated (mean age: 64.1; mean number of medications: 4.4). DDIs were identified in the Micromedex® database. The prevalence of potential DDIs and major DDIs was 63.0% and 12.1%, respectively. In both the univariate and multivariate analyses, the number of drugs prescribed was significantly associated with potential DDIs, with an increasing risk from three to five drugs (OR?=?4.74; 95% CI: 2.90–7.73) to six or more drugs (OR?=?23.03; 95% CI: 10.42–50.91). Forty drugs accounted for 122 pairs of major DDIs, the most frequent of which involved simvastatin (23.8%), captopril/enalapril (16.4%) and fluoxetine (16.4%). Conclusions/Significance This is the first large-scale study on primary care carried out in Latin America. Based on the findings, the estimated prevalence of potential DDIs was high, whereas clinically significant DDIs occurred in a smaller proportion. Exposing patients to a greater number of prescription drugs, especially three or more, proved to be a significant predictor of DDIs. Prescribers should be more aware of potential DDIs. Future studies should assess potential DDIs in primary care over a longer period of time.

Teixeira, Jorge Juarez Vieira; Crozatti, Marcia Terezinha Lonardoni; dos Santos, Carlos Aparecido; Romano-Lieber, Nicolina Silvana

2012-01-01

451

Women Who Abuse Prescription Opioids: Findings from the Addiction Severity Index-Multimedia Version(R) Connect Prescription Opioid Database  

PubMed Central

Background Evidence suggests gender differences in abuse of prescription opioids. This study aimed to describe characteristics of women who abuse prescription opioids in a treatment-seeking sample and to contrast gender differences among prescription opioid abusers. Methods Data collected November 2005 to April 2008 derived from the Addiction Severity Index Multimedia Version Connect (ASI-MV® Connect) database. Bivariate and multivariable logistic regression examined correlates of prescription opioid abuse stratified by gender. Results 29,906 assessments from 220 treatment centers were included, of which 12.8% (N=3,821) reported past month prescription opioid abuse. Women were more likely than men to report use of any prescription opioid (29.8% females vs. 21.1% males, p< 0.001) and abuse of any prescription opioid (15.4% females vs. 11.1% males, p < 0.001) in the past month. Route of administration and source of prescription opioids displayed gender-specific tendencies. Women-specific correlates of recent prescription opioid abuse were problem drinking, age <54, inhalant use, residence outside of West US Census region, and history of drug overdose. Men-specific correlates were age <34, currently living with their children, residence in the South and Midwest, hallucinogen use, and recent depression. Women prescription opioid abusers were less likely to report a pain problem although they were more likely to report medical problems than women who abused other drugs. Conclusions Gender-specific factors should be taken into account in efforts to screen and identify those at highest risk of prescription opioid abuse. Prevention and intervention efforts with a gender-specific approach are warranted.

Green, Traci C.; Grimes Serrano, Jill M.; Licari, Andrea; Budman, Simon H.; Butler, Stephen F.

2009-01-01

452

Relationships Between Self-Reported Unfair Treatment and Prescription Medication Use, Illicit Drug Use, and Alcohol Dependence Among Filipino Americans  

PubMed Central

Objectives. We examined associations between self-reported unfair treatment and prescription medication use, illicit drug use, and alcohol dependence. Methods. We used data from the Filipino American Community Epidemiological Survey, a cross-sectional investigation involving 2217 Filipino Americans interviewed in 1998–1999. Multinomial logistic and negative binomial regression analyses were used in assessing associations between unfair treatment and the substance use categories. Results. Reports of unfair treatment were associated with prescription drug use, illicit drug use, and alcohol dependence after control for age, gender, location of residence, employment status, educational level, ethnic identity level, nativity, language spoken, marital status, and several health conditions. Conclusions. Unfair treatment may contribute to illness and subsequent use of prescription medications. Furthermore, some individuals may use illicit drugs and alcohol to cope with the stress associated with such treatment. Addressing the antecedents of unfair treatment may be a potential intervention route.

Gee, Gilbert C.; Delva, Jorge; Takeuchi, David T.

2007-01-01

453

The role of mental illness in alcohol abuse and prescription drug misuse: gender-specific analysis of college students.  

PubMed

The present study examined whether and how collegians' misuse of prescription drugs and alcohol abuse are associated with mental illness and with a lack of mental health care. Nationally representative data were derived from 5,241 full-time American college students who completed the 2010 National Survey on Drug Use and Health. We observed the presence of alcohol abuse/dependence and the nonmedical use of prescription drugs to be associated with relatively serious mental illness and with lack of health care. In pursuing gender-specific results, we found that the association between alcohol abuse and mental illness was stronger among females than males. PMID:23662330

Lo, Celia C; Monge, Allison N; Howell, Rebecca J; Cheng, Tyrone C

454

Inappropriate drug prescriptions among older nursing home residents: the Italian perspective.  

PubMed

Older people take up a large proportion of health care, including drugs, and evidence shows that drug prescribing to this group is often inappropriate. Negative consequences of potential inappropriate drug prescription (PIDP) include adverse drug events, high healthcare service utilization and high costs for the patients and society. Although nursing home residents are the most vulnerable persons exposed to PIDP, few observational studies have investigated the prevalence, the factors associated with and the consequences of PIDP. Epidemiological studies assessing PIDP mainly based on the Beers' criteria showed that approximately half of US and Canadian nursing home residents have at least one PIDP in this setting. The most frequent inappropriate prescriptions concern neuroleptics and long-term benzodiazepines. Nursing home residents aged 80 years or more, those taking a low number of drugs, cognitive or communication problems are less exposed to PIDP compared with residents younger than 80 years, living in facilities with a high number of beds and a lower registered nurse-to-resident ratio. In European countries, the prevalence of PIDP among older nursing home residents was comparable to or higher than that observed in US and Canadian nursing homes. To date, the issue of PIDP has never been investigated in a representative sample of Italian nursing home residents. In a preliminary study performed by our group in 496 nursing home residents randomly selected from 40 nursing homes in Umbria, the prevalence of residents taking at least one or two inappropriate medications was 28% and 7%, respectively. The prevalence of PIDP considering diagnosis (18%) as well as those regardless of diagnosis (17%), as determined by Beers' criteria, were equally distributed in older Italian nursing home residents and no difference was found between sexes. Overall, this review reveals that the prevalence of PIDP is high in both North American and European nursing homes and highlights the urgent need for intervention trials testing strategies to reduce the health and social burden of PIDP. PMID:20136166

Ruggiero, Carmelinda; Lattanzio, Fabrizia; Dell'Aquila, Giuseppina; Gasperini, Beatrice; Cherubini, Antonio

2009-12-01

455

A review of studies of adherence with antihypertensive drugs using prescription databases  

PubMed Central

Poor adherence with antihypertensive therapies is a major factor in the low rates of blood pressure control among people with hypertension. Patient adherence is influenced by a large number of interacting factors but their exact impact is not well understood, partly because it is difficult to measure adherence. Longitudinal prescription data can be used as a measure of drug supply and are particularly useful to identify interruptions and changes of treatment. Obtaining a medicine does not ensure its use; however, it has been established that continuous collection of prescription medications is a useful marker of adherence. We found 20 studies published in the last 10 years that used large prescription databases to investigate adherence with antihypertensive therapies. These were assessed in terms of patient selection, the definition of the adherence outcome(s), and statistical modeling. There was large variation between studies, limiting their comparability. Particular methodological problems included: the failure to identify an inception cohort, which ensures baseline comparability, in four studies; the exclusion of patients who could not be followed up, which results in a selection bias, in 17 studies; failure to validate outcome definitions; and failure to model the discrete-time structure of the data in all the studies we examined. Although the data give repeated measurements on patients, none of the studies attempted to model patient-level variability. Studies of such observational data have inherent limitations, but their potential has not been fully realized in the modeling of adherence with antihypertensive drugs. Many of the studies we reviewed found high rates of nonadherence to antihypertensive therapies despite differences in populations and methods used. Adherence rates from one database ranged from 34% to 78% at 1 year. Some studies found women had better adherence than men, while others found the reverse. Novel approaches to analyzing data from such databases are required to use the information available appropriately and avoid the problems of bias.

Fitz-Simon, Nicola; Bennett, Kathleen; Feely, John

2005-01-01

456

Demographics, health behaviors, and past drug use as predictors of recall accuracy for previous prescription medication use  

Microsoft Academic Search

Drug data for pharmacoepidemiologic studies are often ascertained by self-report, but little research has addressed the factors influencing its accuracy. Stratified random sampling was used to select individuals for a study comparing interview data on past prescription drug use with dispensation information from the Group Health Cooperative of Puget Sound pharmacy database. The strata included age, gender, and recency of

Suzanne L. West; David A. Savitz; Gary Koch; Karen L. Sheff; Brian L. Strom; Harry A. Guess; Abraham G. Hartzema

1997-01-01

457

Controlling Prescription Drug Costs: Regulation and the Role of Interest Groups in Medicare and the Veterans Health Administration  

Microsoft Academic Search

Medicare and the Veterans Health Administration (VA) both finance large outpatient prescription drug programs, though in very different ways. In the ongoing debate on how to control Medicare spending, some suggest that Medicare should negotiate directly with drug manufacturers, as the VA does. In this article we relate the role of interest groups to policy differences between Medicare and the

Austin B. Frakt; Steven D. Pizer; Ann M. Hendricks

2008-01-01

458

Age and the purchase of prescription drug insurance by older adults  

PubMed Central

The Medicare Part D Prescription Drug Program places an unprecedented degree of choice in the hands of older adults despite concerns over their ability to make effective decisions and desire to have extensive choice in this context. While previous research has compared older adults to younger adults along these dimensions, our study, in contrast, examines how likelihood to delay decision making and preferences for choice differ by age among older age cohorts. Our analysis is based on responses of older adults to a simulation of enrollment in Medicare Part D. We examine how age, numeracy, cognitive reflection, and the interaction between age and performance on these instruments are related to the decision to enroll in a Medicare prescription drug plan and preference for choice in this context. We find that numeracy and cognitive reflection are positively associated with enrollment likelihood and that they are more important determinants of enrollment than age. We also find that greater numeracy is associated with a lower willingness to pay for choice. Hence, our findings raise concern that older adults, and, in particular, those with poorer numerical processing skills, may need extra support in enrolling in the program: they are less likely to enroll than those with stronger numerical processing skills, even though they show greater willingness to pay for choice.

Szrek, Helena; Bundorf, M. Kate

2011-01-01

459

The economics of direct-to-consumer advertising of prescription-only drugs: prescribed to improve consumer welfare?  

PubMed

According to economic theory, one might expect that the informational content of direct-to-consumer advertising of prescription-only drugs would improve consumers' welfare. However, contrasting the models of consumer and market behaviour underlying this theory with the realities of the prescription-only drug market reveals that this market is distinct in ways that render it unlikely that advertising will serve an unbiased and strictly informative function. A review of qualitative evidence regarding the informational content of drug advertising supports this conclusion. Direct-to-consumer prescription drug advertising concentrates on particular products, and features of those products, to the exclusion of others, and the information provided has frequently been found to be biased or misleading in regulatory and academic evaluations. Governments that have so far resisted direct-to-consumer advertising should invest in independent sources of evidence that could help consumers and professionals to better understand the risks and benefits of treating disease with alternative drug and non-drug therapies, rather than permitting direct-to-consumer prescription drug advertising. PMID:14596759

Morgan, Steven; Mintzes, Barbara; Barer, Morris

2003-10-01

460

Estimating Long-term Trends in the Incidence and Prevalence of Opiate Use\\/ Injecting Drug Use and the Number of Former Users: Back-Calculation Methods and Opiate Overdose Deaths  

Microsoft Academic Search

The authors explored an age-specific back-calculation approach to estimating long-term trends in the incidence and prevalence of opiate use\\/injecting drug use (IDU) in England for 1968-2000. The incidence of opiate use\\/ IDU was estimated by combining information on the observed opiate overdose deaths of persons aged 15-44 years with knowledge on the distribution of the time between starting opiate use\\/IDU

Daniela De Angelis; Matthew Hickman; Shuying Yang

2004-01-01

461

Overdose and prescribed opioids: Associations among chronic non-cancer pain patients  

PubMed Central

Background Chronic opioid therapy for chronic non-cancer pain (CNCP) is increasingly common in community practice. Concomitant with this practice change, rates of fatal opioid overdose have increased. It is not known to what extent overdose risks are elevated among patients receiving medically prescribed chronic opioid therapy. Objective To estimate rates of opioid overdose and their association with average prescribed daily opioid dose among patients receiving medically prescribed chronic opioid therapy. Design Cox proportional hazards models were used to estimate overdose risk as a function of average daily opioid dose (morphine equivalents) received at time of overdose. Setting Health maintenance organization. Patients Individuals (n=9940) who received 3+ opioid prescriptions within 90-days for CNCP between 1997 and 2005. Measurements Average daily opioid dose over the previous 90 days from automated pharmacy data. Primary outcomes, non-fatal and fatal overdoses, were identified through diagnostic codes from inpatient and outpatient care and death certificates and confirmed by medical record review. Results Fifty-one opioid-related overdoses were identified, including six deaths. Compared to patients receiving 1-20mg of opioids per day (0.2% annual overdose rate), patients receiving 50-99 mg had a 3.7 fold increase in overdose risk (95% C.I. 1.5, 9.5) and a 0.7% annual overdose rate. Patients receiving 100mg or more per day had an 8.9 fold increase in overdose risk (95% C.I. 4.0, 19.7) and a 1.8% annual overdose rate. Limitations Increased overdose risk among patients on higher dose regimens may be due to confounding by patient differences and by use of opioids in ways not intended by prescribing physicians. The small number of overdoses in the study cohort is also a limitation. Conclusions Patients receiving higher doses of prescribed opioids are at increased risk of opioid overdose, underscoring the need for close supervision of these patients.

Dunn, Kate M; Saunders, Kathleen W; Rutter, Carolyn M; Banta-Green, Caleb J; Merrill, Joseph O; Sullivan, Mark D; Weisner, Constance M; Silverberg, Michael J; Campbell, Cynthia I; Psaty, Bruce M; Von Korff, Michael

2010-01-01

462

Hydrocodone/oxycodone overdose  

MedlinePLUS

Hydrocodone and oxycodone belong to a class of narcotic medications called opiates. These medications are man-made ... medicines may also be combined with a non-narcotic medicine, acetaminophen (Tylenol). See also: Acetaminophen overdose

463

Hydrocodone and acetaminophen overdose  

MedlinePLUS

... levels in the blood (N-acetylcysteine) Medicine to reverse the effect of the hydrocodone (narcotic antagonist) Tube ... for recovery. If you can receive medicines to reverse the overdose, you may get better within 1 - ...

464

Zinc oxide overdose  

MedlinePLUS

Zinc oxide is an ingredient in many products, including certain creams and ointments used to prevent or treat minor skin burns and irritation. Zinc oxide overdose occurs when someone accidentally or intentionally ...

465

Who Are the Opinion Leaders? The Physicians, Pharmacists, Patients, and Direct-to-Consumer Prescription Drug Advertising  

Microsoft Academic Search

A popular perception holds that physicians prescribe requested drugs to patients influenced by mass mediated direct-to-consumer prescription drug advertising. The phenomenon poses a serious challenge to the two-step flow model, which emphasizes the influence of opinion leaders on their followers and their legitimating power over the informing power of the mass media. This study investigates a 2002 Food and Drug

Annisa Lai Lee

2010-01-01

466

A review of geographic variation and Geographic Information Systems (GIS) applications in prescription drug use research.  

PubMed

BACKGROUND: While understanding geography's role in healthcare has been an area of research for over 40 years, the application of geography-based analyses to prescription medication use is limited. The body of literature was reviewed to assess the current state of such studies to demonstrate the scale and scope of projects in order to highlight potential research opportunities. OBJECTIVE: To review systematically how researchers have applied geography-based analyses to medication use data. METHODS: Empiric, English language research articles were identified through PubMed and bibliographies. Original research articles were independently reviewed as to the medications or classes studied, data sources, measures of medication exposure, geographic units of analysis, geospatial measures, and statistical approaches. RESULTS: From 145 publications matching key search terms, forty publications met the inclusion criteria. Cardiovascular and psychotropic classes accounted for the largest proportion of studies. Prescription drug claims were the primary source, and medication exposure was frequently captured as period prevalence. Medication exposure was documented across a variety of geopolitical units such as countries, provinces, regions, states, and postal codes. Most results were descriptive and formal statistical modeling capitalizing on geospatial techniques was rare. CONCLUSION: Despite the extensive research on small area variation analysis in healthcare, there are a limited number of studies that have examined geographic variation in medication use. Clearly, there is opportunity to collaborate with geographers and GIS professionals to harness the power of GIS technologies and to strengthen future medication studies by applying more robust geospatial statistical methods. PMID:23333430

Wangia, Victoria; Shireman, Theresa I

2013-01-17

467

Direct-to-consumer marketing of prescription drugs: a current perspective for neurologists and psychiatrists.  

PubMed

In the US and New Zealand, the past decade has seen tremendous growth in the marketing of prescription drugs directly to patients. The pharmaceutical industry has applied pressure in other countries to relax regulations governing such marketing although this has not yet been successful. While we still have much to learn about the potential impact on the public's health of direct-to-consumer (DTC) marketing, some data are available. This article summarises the current literature on the benefits and risks of DTC marketing. This marketing strategy has grown substantially in the US, but only select drugs are advertised. Whether there is net benefit or harm to the public's health as a result of DTC marketing depends critically on which drugs are advertised and the quality of the information provided in promotional material. Critical reviews of this promotional material suggest the information is of poor quality. Notably, 18% of the 50 drugs advertised most intensively in the US were medications used to treat psychiatric and neurological disorders. The impairments in decisional capacity often seen in psychiatric and neurological illness leave patients vunerable to the controlling influence of DTC marketing and, thus, undermine the patient autonomy that is said to be promoted by this marketing strategy. If there is any benefit from DTC marketing it is for significantly undertreated conditions. International restrictions on DTC marketing should remain in place until further evidence of net benefit or harm emerges from the DTC marketing experiment that is taking place in the US and New Zealand. PMID:14728054

Hollon, Matthew F

2004-01-01

468

Distinguishing signs of opioid overdose and indication for naloxone: an evaluation of six overdose training and naloxone distribution programs in the United States  

PubMed Central

Aims This study assessed overdose and naloxone administration knowledge among current or former opioid abusers trained and untrained in overdose–response in the United States. Design and participants Ten individuals, divided equally between those trained or not trained in overdose recognition and response, were recruited from each of six sites (n = 62). Setting US-based overdose training and naloxone distribution programs in Baltimore, San Francisco, Chicago, New York and New Mexico. Measurements Participants completed a brief questionnaire on overdose knowledge that included the task of rating 16 putative overdose scenarios for: (i) whether an overdose was occurring and (ii) if naloxone was indicated. Bivariate and multivariable analyses compared results for those trained to untrained. Responses were also compared to those of 11 medical experts using weighted and unweighted kappa statistics. Findings Respondents were primarily male (72.6%); 45.8% had experienced an overdose and 72% had ever witnessed an overdose. Trained participants recognized more opioid overdose scenarios accurately (t60 = 3.76, P < 0.001) and instances where naloxone was indicated (t59 = 2.2, P < 0.05) than did untrained participants. Receipt of training and higher perceived competency in recognizing signs of an opioid overdose were associated independently with higher overdose recognition scores. Trained respondents were as skilled as medical experts in recognizing opioid overdose situations (weighted kappa = 0.85) and when naloxone was indicated (kappa = 1.0). Conclusions Results suggest that naloxone training programs in the United States improve participants’ ability to recognize and respond to opioid overdoses in the community. Drug users with overdose training and confidence in their abilities to respond may effectively prevent overdose mortality.

Green, Traci C.; Heimer, Robert; Grau, Lauretta E.

2011-01-01

469

Charges billed to third parties for prescription drugs furnished by VA to a veteran for a nonservice-connected disability. Final rule.  

PubMed

This document amends the medical regulations of the Department of Veterans Affairs (VA) concerning ``reasonable charges'' for medical care or services provided or furnished by VA to a veteran for a nonservice-connected disability. More specifically, VA amends the regulations regarding charges billed for prescription drugs not administered during treatment by changing the billing formula to reflect VA's actual drug costs for each drug rather than using a national average drug cost for all prescriptions dispensed. The revised formula for calculating reasonable charges for prescription drug costs will also continue to include an average administrative cost for each prescription. The purpose is to provide VA with a more accurate billing methodology for prescription drugs. PMID:20931727

2010-10-01

470

Childhood abuse related to nicotine, illicit and prescription drug use by women: pilot study.  

PubMed

A sample of 811 women ages 18 to 59 (M=26.0, SD=6.5) responded to an advertisement by telephone. Inquiries were made about childhood abuse status and adult use of alcohol, nicotine, and prescription and illicit drugs. Significant associations were noted for reported sexual, physical, and emotional childhood abuse with use of nicotine, marijuana, and antidepressants in adulthood. Reported childhood physical and emotional abuses were also significantly associated with use of cocaine and anxiolytics, and sexual abuse with antipsychotic use in adulthood. Only childhood emotional abuse was associated with the use of sleeping pills. Number of types of abuse was significantly related with use of nicotine, marijuana, cocaine, antidepressants, antipsychotics, and anxiolytics. Alcohol use was not related to any type of abuse. The long-term effects of childhood emotional abuse may be just as severe as physical or sexual abuse. PMID:19102471

Pederson, Cathy L; Vanhorn, Daniel R; Wilson, Josephine F; Martorano, Lisa M; Venema, Jana M; Kennedy, Sarah M

2008-10-01

471

The unlicensed lives of antidepressants in India: generic drugs, unqualified practitioners, and floating prescriptions.  

PubMed

Antidepressant uses have been rising rapidly over the past decades. Two main theories have been advanced to explain this. One claims that socio-economic change causes a global rise of depressive illness. The other holds that European and North American corporations are aggressively marketing antidepressants to expand their global reach. Both theories assume that multinational capitalism drives rising depression rates. Based on ethnographic data from India, this article shows that antidepressants are increasingly used in this country as well, but for reasons than have been little explored yet. Taking fluoxetine (Prozac) as the main example, it is argued that the spread of antidepressants in India is ;unlicensed' by Euro-American corporations in at least three ways: (i) drug marketing is driven by Indian generic producers; (ii) fluoxetine is given by practitioners who have no license to do so; and (iii) knowledge of fluoxetine is spread through unlicensed ;floating' prescriptions that patients take from one prescriber to another. PMID:19293281

Ecks, Stefan; Basu, Soumita

2009-03-01

472

Hidden in plain sight marketing prescription drugs to consumers in the twentieth century.  

PubMed

Although the public health impact of direct-to-consumer (DTC) pharmaceutical advertising remains a subject of great controversy, such promotion is typically understood as a recent phenomenon permitted only by changes in federal regulation of print and broadcast advertising over the past two decades. But today's omnipresent ads are only the most recent chapter in a longer history of DTC pharmaceutical promotion (including the ghostwriting of popular articles, organization of public-relations events, and implicit advertising of products to consumers) stretching back over the twentieth century. We use trade literature and archival materials to examine the continuity of efforts to promote prescription drugs to consumers and to better grapple with the public health significance of contemporary pharmaceutical marketing practices. PMID:20299640

Greene, Jeremy A; Herzberg, David

2010-03-18

473

Differences in prescription drug use in HMO and self-insured health plans.  

PubMed

Using pharmacy benefits manager claims data, this study analyzed how cost-management techniques including cost sharing affected enrollees in health maintenance organizations (HMOs) versus employer-sponsored fee-for-service plans. Because HMOs bear the risk of pharmaceutical costs and influence the prescribing practices of the physicians in their network, we expected different patterns of prescription use, such as proportionately more generic medications in HMOs. Also, because HMO physicians are likely to prescribe relatively more drugs for high-severity conditions, HMO enrollee demand should be less price sensitive. The impact of cost sharing was found to be significantly less for HMOs. A 5-dollar increase in copayments decreased expenditures by 16 percent in fee-for-service plans but only by 1 percent in HMOs. Furthermore, when cost sharing was set at zero, HMO plans were found to have significantly fewer and cheaper medications, resulting in lowe