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Methadone Prescribing for Pain Management in Pennsylvania per the Prescription Drug Monitoring Program, 2016–2020

Introduction Methadone is a schedule II opioid traditionally used to treat opioid use disorder (OUD) and chronic pain. However, following the identification of its contribution to opioid overdose deaths, methadone has become less commonly used for chronic pain indications. In Pennsylvania (PA), pres...

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Autores principales: Adalbert, Jenna R, Varshney, Karan, Hom, Jeffrey, Ilyas, Asif M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9521395/
https://www.ncbi.nlm.nih.gov/pubmed/36185908
http://dx.doi.org/10.7759/cureus.28583
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author Adalbert, Jenna R
Varshney, Karan
Hom, Jeffrey
Ilyas, Asif M
author_facet Adalbert, Jenna R
Varshney, Karan
Hom, Jeffrey
Ilyas, Asif M
author_sort Adalbert, Jenna R
collection PubMed
description Introduction Methadone is a schedule II opioid traditionally used to treat opioid use disorder (OUD) and chronic pain. However, following the identification of its contribution to opioid overdose deaths, methadone has become less commonly used for chronic pain indications. In Pennsylvania (PA), prescribers are required to report methadone prescriptions written for pain indications to the prescription drug monitoring program (PDMP), which is an electronic database that enhances the tracking and reporting of prescription data. The primary objective of our study was to describe the geographic methadone prescribing trends recorded by the PA PDMP in order to report methadone’s current use for only pain indications.  Methods State- and county-level methadone prescription data summaries recorded by the PA PDMP for each calendar quarter from August 2016 through March 2020 were collected from the PA Department of Health. The metric reported per quarter consisted of the total number of methadone prescriptions dispensed for pain indications unrelated to OUD. Results A total of 341,949 methadone prescriptions were dispensed in PA from the third quarter (Q3) of 2016 to the first quarter (Q1) of 2020 (range = 1106) with an overall 38.7% decrease in methadone prescriptions and a change in the rate of 85.97 per 100,000 population. The counties with the five highest prescription totals were Philadelphia, Allegheny, Bucks, Montgomery, and York (range = 46,969), and the counties with the five highest rates per 100,000 were Montour, Green, Columbia, Northumberland, and Forest (range = 964). Conclusions Methadone prescribing for pain management unrelated to OUD has decreased in PA from 2016 to 2020 per the PA PDMP. However, it is still prescribed in appreciable amounts for pain management. Further studies are required to understand the prescribing rationale and potential areas for harm reduction interventions.
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spelling pubmed-95213952022-09-30 Methadone Prescribing for Pain Management in Pennsylvania per the Prescription Drug Monitoring Program, 2016–2020 Adalbert, Jenna R Varshney, Karan Hom, Jeffrey Ilyas, Asif M Cureus Pain Management Introduction Methadone is a schedule II opioid traditionally used to treat opioid use disorder (OUD) and chronic pain. However, following the identification of its contribution to opioid overdose deaths, methadone has become less commonly used for chronic pain indications. In Pennsylvania (PA), prescribers are required to report methadone prescriptions written for pain indications to the prescription drug monitoring program (PDMP), which is an electronic database that enhances the tracking and reporting of prescription data. The primary objective of our study was to describe the geographic methadone prescribing trends recorded by the PA PDMP in order to report methadone’s current use for only pain indications.  Methods State- and county-level methadone prescription data summaries recorded by the PA PDMP for each calendar quarter from August 2016 through March 2020 were collected from the PA Department of Health. The metric reported per quarter consisted of the total number of methadone prescriptions dispensed for pain indications unrelated to OUD. Results A total of 341,949 methadone prescriptions were dispensed in PA from the third quarter (Q3) of 2016 to the first quarter (Q1) of 2020 (range = 1106) with an overall 38.7% decrease in methadone prescriptions and a change in the rate of 85.97 per 100,000 population. The counties with the five highest prescription totals were Philadelphia, Allegheny, Bucks, Montgomery, and York (range = 46,969), and the counties with the five highest rates per 100,000 were Montour, Green, Columbia, Northumberland, and Forest (range = 964). Conclusions Methadone prescribing for pain management unrelated to OUD has decreased in PA from 2016 to 2020 per the PA PDMP. However, it is still prescribed in appreciable amounts for pain management. Further studies are required to understand the prescribing rationale and potential areas for harm reduction interventions. Cureus 2022-08-30 /pmc/articles/PMC9521395/ /pubmed/36185908 http://dx.doi.org/10.7759/cureus.28583 Text en Copyright © 2022, Adalbert et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Pain Management
Adalbert, Jenna R
Varshney, Karan
Hom, Jeffrey
Ilyas, Asif M
Methadone Prescribing for Pain Management in Pennsylvania per the Prescription Drug Monitoring Program, 2016–2020
title Methadone Prescribing for Pain Management in Pennsylvania per the Prescription Drug Monitoring Program, 2016–2020
title_full Methadone Prescribing for Pain Management in Pennsylvania per the Prescription Drug Monitoring Program, 2016–2020
title_fullStr Methadone Prescribing for Pain Management in Pennsylvania per the Prescription Drug Monitoring Program, 2016–2020
title_full_unstemmed Methadone Prescribing for Pain Management in Pennsylvania per the Prescription Drug Monitoring Program, 2016–2020
title_short Methadone Prescribing for Pain Management in Pennsylvania per the Prescription Drug Monitoring Program, 2016–2020
title_sort methadone prescribing for pain management in pennsylvania per the prescription drug monitoring program, 2016–2020
topic Pain Management
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9521395/
https://www.ncbi.nlm.nih.gov/pubmed/36185908
http://dx.doi.org/10.7759/cureus.28583
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