Some Drug Abusers Use Relatives to ‘Opioid Shop’

By Robert Preidt

HealthDay Reporter

FRIDAY, May 10, 2019 (HealthDay News) — People who are thwarted in their attempts to “shop around” for prescription opioid painkillers at doctors’ offices and pharmacies may try to get the drugs via relatives as a last resort, researchers report.

Some people who misuse opioids go to numerous prescribers and fill prescriptions at multiple pharmacies to avoid detection. But states are cracking down on such “shopping,” forcing them to find other ways of getting the drugs.

The new study suggests some try to get opioids from family members who are prescribed the painkillers. University of Michigan researchers said it’s the first study to examine doctor and pharmacy shopping within families.

For every 200 U.S. patients prescribed opioids in 2016, one had a family member who shopped for opioids, the study found.

The findings underscore the need to reduce the number of opioids available for such diversion by limiting unnecessary prescribing, according to authors of the study published May 10 in the journal JAMA Network Open.

The researchers analyzed 1.4 million opioid prescriptions in 2016 for 554,000 people and relatives covered under the same private family insurance plan.

Of those prescriptions, 0.6% (1 out of 167) were filled by a patient with a family member who met the criteria for opioid shopping — they had received prescriptions from four or more sources and filled them at four or more pharmacies in the past year.

That percentage means that 1.2 million of the 210 million opioid prescriptions in the United States in 2016 may have been dispensed to people who had family members who shopped for opioids, said lead author Dr. Kao-Ping Chua and colleagues.

When researchers defined opioid shopping as getting prescriptions from at least three sources and filling them at three or more pharmacies, 1.9% of opioid prescriptions met that criteria.

For opioid prescriptions to children, 0.2% were filled when the child, doctor and pharmacy met opioid shopping criteria, the study found.

And 0.7% of opioid prescriptions to kids went to those with a family member who met pharmacy shopping criteria. Though researchers can’t be sure from their data, they suspect the adults were often the children’s parents.


“This apparent doctor and pharmacy shopping behavior in children is likely driven by an adult family member, since children can’t obtain opioid prescriptions from multiple prescribers and fill them at multiple pharmacies on their own,” Chua said in a university news release. He’s a pediatrician and health care researcher at Michigan.

To prevent people who shop for opioids from misusing family members’ medicine, Chua said doctors should not prescribe more doses than patients need, and should order over-the-counter painkillers when possible.

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SOURCE: University of Michigan, news release, May 10, 2019

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In the ICU, Patients’ Relatives Often Mum About Care Concerns

THURSDAY, July 19, 2018 — Many family members of intensive care unit (ICU) patients are reluctant to tell medical staff of worries about their loved one’s care, a new study finds.

“Speaking up is a key component of safety culture, yet our study — the first to our knowledge to address this issue — revealed substantial challenges for patients and families speaking up during an ICU stay,” said study co-author Dr. Sigall Bell. She’s director of patient safety and discovery at OpenNotes at Beth Israel Deaconess Medical Center in Boston.

Bell and her team surveyed 105 families of patients admitted to an academic hospital’s ICU between July 2014 and February 2015. The researchers also conducted an internet survey of 1,050 people with recent ICU experience.

Nearly two-thirds of ICU patients and families said they felt very comfortable talking to medical staff about medications, but only one-third said they felt comfortable bringing up concerns about hand hygiene or aggressiveness of care.

Only half the respondents said they were very comfortable asking for clarification about confusing or conflicting information or raising concerns about a possible error. The main reasons for their reluctance were fear of being labeled a “troublemaker,” not knowing which person to talk to, and the medical team being very busy.

Younger people, men and those without personal experience in health care were less likely speak up, according to the researchers.

The study authors noted that the people included in the study were English-only speakers and many were college-educated and had connections to the health care industry, so the findings likely underestimate the problem.

The findings were published July 12 in the journal BMJ Quality and Safety.

“In the ICU setting in particular, families — who are also among the most vigilant stakeholders — may hold key information clinicians may have overlooked, and may be the first to detect a change in clinical status,” Bell said in a Beth Israel news release.

“Our findings are important because true partnerships with patients and families may be limited if they don’t feel supported to voice their concerns,” she said.

“Our results highlight the need to explicitly support patients and families to speak up in real time about perceived errors. Hesitancy to do so represents a real safety gap,” Bell said.

More information

The U.S. Centers for Disease Control and Prevention outlines how you can be a safe patient.

© 2018 HealthDay. All rights reserved.

Posted: July 2018 – Daily MedNews

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After Death of a Spouse, Friends Might Help More Than Relatives

MONDAY June 16, 2014, 2014 — When a spouse dies, the surviving husband or wife often will deeply feel the loss of a close confidant.

But a new study, published in the June issue of Health Psychology, finds that they may be better off in terms of their future health by turning to a close friend rather than a close relative.

“Friendships are discretionary while family relationships are obligatory, and past research shows that obligatory relationships can be less beneficial than discretionary relationships during times of stress,” study co-author Jamila Bookwala said in a news release from Academy Communications.

Bookwala, a psychology professor at Lafayette College in Easton, Pa., and her team tracked nearly 750 Americans — mostly older women — from 1992 to 2004. The researchers looked for connections between better physical health and the presence of a close confidant.

Those who received emotional support from relatives didn’t fare as well in terms of health as those with friends, the investigators found.

What’s going on?

“Family relationships are more likely to be characterized by ambivalence than are friendships,” Bookwala said. “Such ambivalence — feeling both close and bothered by the person — may occur even within confidant relationships with family members. This ambivalence may reduce the likelihood of health benefits from confiding in a family member.”

But a close relationship with a friend “is likely to be less emotionally complex, less ambivalent,” she said.

“As a result,” Bookwala explained, “having a friend to confide in may be more conducive to protecting health in the face of stress, such as becoming widowed. And this may explain why having a family member to confide in resulted in no protective health benefits for those whose spouse died, but having a friend to confide in did.”

More information

For more about mourning the death of a spouse, visit the U.S. National Institute on Aging.

Posted: June 2014

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Extra Help Enhances Holidays for Older Relatives

SUNDAY Dec. 18, 2011 — The holiday season is a time for family gatherings and it’s important to include grandparents and other elderly relatives, experts say.

It is also important to consider the special needs of these older family members, according to a news release from Ryerson University in Toronto.

Some older adults may need to be picked up by car. This could be done by newly licensed grandchildren, giving the two generations an opportunity to share, connect and bond.

Keep in mind that hearing loss can be an issue for older guests. Place someone close to them at the dinner table who can repeat parts of the conversations or assist them in other ways.

Watch for when older people appear not to be part of the conversation. You can help make them feel included by asking them about their life experiences.

Bringing out old photo albums is another way to engage older family members. They can fill everyone in on the names of people, times, events and locations in the photos.

While some older adults are highly independent and don’t like it when younger adult relatives try to “parent” them, others are dependent on their adult relatives in some ways. Being sensitive to these situations will improve your communications with an older family member and help everyone enjoy their time together.

If you’re visiting an older relative in a long-term care facility, bring young children and perhaps even the family dog or cat, if the facility allows it. It might also be a good idea to bring familiar foods from your family’s traditions and decorate a small area of the room with items that have been used in family celebrations for many years.

More information

The AGS Foundation for Health in Aging offers tips for beating the holiday blues.

Posted: December 2011

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