91AV

Research from Assistant Professor and Vice Chair of the Department of Pharmacy Practice Leslie Ochs, Pharm.D., Ph.D., MSPH, is featured in two medical journals.

Ochs teamed with three other researchers, including Heather Stewart, Pharm.D. ’14, to characterize and quantify controlled substances dropped off at community medication take back events.

Accumulated home medications can serve as a source for poisonings, abuse and misuse.

“It’s important to understand how much medication is being prescribed and returned unused to these community events,” said Ochs.

Ochs and the other researchers logged returned medications at events in six different states, including Maine, from 2011 to 2015.

“Not only are we collecting unused medications, we are having both medical and pharmacy students help us log the different types of medications that are being brought back,” she said.

More than 10,000 prescriptions were collected and logged from those events.

“For the scheduled medications, which are the pain medications or the opioids, we were concerned with over prescribing,” said Ochs.

Significant quantities of controlled prescription medications were returned over the five-year study period, indicating that many patients are prescribed quantities significantly greater than what they use.

“What we found was that nearly half of the medications prescribed came back unused,” she said.

Average prescription waste exceeded 50 percent of the prescribed quantity in all nine controlled medication categories. The greatest waste occurred with pregabalin (74.8 percent), followed by fentanyl (70.1 percent) and morphine (68.4 percent).

The study concluded that all aspects of controlled substance supply and demand must be scrutinized; including prescribing and dispensing practices, utilization, disposal and diversion of these medications.

Recommendations include prescription limitations. The Centers for Disease Control and Prevention (CDC) is recommending limitations such as a 3-day or 7-day supply of controlled prescription medications for acute pain and a 30-day limit for chronic pain. The CDC is also recommending frequent evaluations of the patients.

The study was published in the Journal of Substance Use.

In a separate study, Ochs teamed up with five other researchers to study the overuse of Gabapentin, a treatment for nerve pain.

Gabapentin has become more popular in recent years as patients and providers look for non-opioid medications to treat pain. The study’s aim was to determine if patients were more likely to overuse Gabapentin while using opioids at the same time.

Their study found that the likelihood of Gabapentin overuse alone is low, but overuse of this medication significantly increases with concomitant opioid use, especially when coupled with a history of addiction.

The study was published in Pharmacotherapy, one of the top journals for clinical pharmacists.

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