Prescription Drug Abuse Rocks Health Care Delivery System

America's health care delivery system is in chaos over the prescription drug abuse epidemic. Brokers, providers and insureds are turning to the pros to stem the tide, protect the safety of patients, and control liability.

The National Institute on Drug Abuse reports these shocking statistics:

- “52 Million people in the US, over the age of 12, have used prescription drugs non-medically in their lifetime.”
- “6.1 Million people have used them non-medically in the past month.”
- “25 percent of the United States consumes 75 percent of the world's prescription drugs.”
- “In 2010, enough prescription painkillers were prescribed to medicate every American adult every 4 hours for 1 month.”

The abuse in question focuses on a specific class of drugs: opiate-based painkillers.  “Every year,” the CDC adds, “nearly 15,000 people die from overdoses involving these drugs—more than those who die from heroin and cocaine combined… Overdoses involving prescription painkillers—a class of drugs that includes hydrocodone, methadone, oxycodone, and oxymorphone -- are a public health epidemic. These drugs are widely misused and abused.”

Medscape reports these equally astounding statistics on the financial burden this imposes on the health care system:  “The U.S. spends $200 billion each year — about 8 percent of the nation’s health care tab — on medical care stemming from improper or unnecessary use of prescription drugs.”

A significant dose of those expenses come from unwarranted hospital stays and doctor visits, discloses a study by the IMS Health’s Institute for Healthcare Informatics, a provider of data to the health care industry.  A wide swath of components contributes: medical bills are more due to patients who get the wrong meds or fail to take the right ones, misuse of antibiotics, medication mistakes and poor management of patients who take multiple drugs.

Michelle Foster Earle, a co-founder in OmniSure and longtime professional risk manager and industry consultant, explains how the convergence of these factors impacts the health industry: “Health care providers and their professional liability carriers are getting scared. So many variables are at play that the carriers, pharmacies, doctor’s offices and hospitals often don’t know what to do. The carrier wants to make sure a pain clinic isn’t a pill mill. The clinic wants to treat the patient’s pain but not overdose him, especially if he presents with a history of addiction or dependence.  The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends proactive dispensing of Naloxone for people at high risk of overdose.  Others oppose. And all just want to ensure the provision of safe and effective care. Oftentimes calling a clinical risk management professional is the smartest and only thing to do for concerned people in the trenches.”

Potentially fatal consequences are at stake for everyone involved.  Compounding the drug abuse problem is the worst possible development imaginable: “Overdose deaths from prescription painkillers have skyrocketed in the past decade. Every year, nearly 15,000 people die from overdoses involving these drugs—more than those who die from heroin and cocaine combined,” reports the CDC.  Indeed, “Nearly half a million emergency department visits in 2009 were due to people misusing or abusing prescription painkillers… Nonmedical use of prescription painkillers costs health insurers up to $72.5 billion annually in direct health care costs” alone.

“The number of choices the health care system faces is mindboggling,” explains Mrs. Foster Earle. “And every state can be different. What one requires another does not. Brokers and carriers alike consult with us because we access a nationwide network of specialists – insurers, lawyers, regulatory specialists, clinical consultants, and other medical professionals – all of which weigh in to resolve the countless and unending issues that arise. The goals are simple: quality care, patient and employee safety, preventing costly lawsuits and claims, avoiding negative publicity.  But managing and juggling all of these balls at once is a prodigious undertaking that takes a team effort until we get this epidemic under control.”

Epidemics are by nature extraordinarily challenging.  Clearly, the prescription drug abuse epidemic is no exception.


Bring in a specialist when looking for the best risk management strategy. Within each area of specialization – healthcare, senior living, social services, design professionals and staffing firms – Omnisure has a deep bench of talent whose consultants are industry specialists with unique skill sets based on years of experience working in chosen fields. Each specialist is assigned based on a particular area of specialization to meet clients’ industry-specific needs. And what you get with OmniSure isn’t just the experience of one individual, but rather the collective wisdom of the entire team of consultants.

Contact Info:
Name: Michelle Foster Earle
Email: Send Email
Organization: OmniSure
Phone: 800.942.4140

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Release ID: 68881