OXNARD, Calif. – The Ventura County Behavioral Health Department was awarded the prestigious Quality Leaders Award for “Data Driven Organization” from the California Association of Public Hospitals and Health Systems (CAPH) at their annual conference this month, recognizing Ventura County’s focus on prescription drug abuse prevention.
Drug overdose is now the leading cause of accidental death in America, far surpassing motor vehicle deaths in recent years. In Ventura County, there are between 60 and 90 accidental deaths each year involving prescription medications, a trend that the Health Care Agency and allied organizations are working to change. Alprazolam, more commonly known by the name-brand Xanax®, is very commonly associated with drug diversion and abuse—especially in combination with alcohol or other drugs. But it is no longer the drug of first choice for most anxiety-involved conditions, as it can be highly addictive and long-term use has shown to have very little medical benefit.
Focused on reducing morbidity, mortality, and drug diversion, the Behavioral Health Department incorporated best practices for medical decision-making over the last three years, by requiring doctors to use CURES, California’s Prescription Drug Monitoring Program, for prescribers; creating medication treatment agreements between doctors and their patients; and giving physicians a ‘prescriber report card’ so they can see how their prescribing of alprazolam (Xanax®) compares with other health professionals.
The result was a dramatic reduction in alprazolam and other benzodiazepine prescribing among the County doctors. In fact, the safe prescribing project reduced the number of alprazolam prescriptions by 70 percent; making alprazolam now just slightly more than one percent of the Department’s total active prescriptions. Prescribing of other benzodiazepines like clonazepam and lorazepam also trended downward as a result of the new approach.
One key to success was the use of formal agreements between County psychiatrists and their patients. Doctors doubled their rate of using medication treatment agreements with their patients, and now, nearly 90 percent of all cases have a formal agreement on drug-involved care. Another key to change was the fact that doctors ran a CURES report 98 percent of the time. This report, which comes from the revamped State website, allows a prescriber to better understand patterns of use, and risk factors for drug abuse, interactions and overdose.
“Sadly, some patients were surprised to find out about these risks, including dependence and even overdose. The reason was simply that providers had almost never taken the time to educate them about what they were getting into,” said Dr. Brian Taylor, who co-led the Safe Prescribing project with Dr. Celia Woods. “By giving doctors new perspectives on their own prescribing, incorporating routine urine drug screens, and using evidence-based strategies for better treatment, we actually got to a much better place, a place of much higher awareness of drug risks, but where the clinical outcomes are still very good, and patient safety is much improved.”