Prescription Drug Monitoring

Abuse of prescription drugs is a national epidemic according to our own national Center for Disease Control and Prevention. State governments and law enforcement are working hard to get control over a problem that is rampant all across the country. One major thrust has been the establishment of prescription drug monitoring programs. To date, 49 states are in the process or have monitoring programs currently in operation. The programs have already proven useful in identifying trouble spots. The problem is that there is not uniformity between states in how data is collected, used and distributed.

The number of prescriptions being written, especially for opioid narcotics, is at an all-time high. So are the number of emergency room visits associated with opioid abuse, the number of citizens addicted to them and the number of fatal overdoses. In some states, drug overdoses are responsible for more citizen deaths than automobile accidents.

The prescription drug abuse problem is unique in that the substances are being obtained through legal channels. Prescription drug monitoring programs are designed to keep track of the drugs in order to prevent abuse. In order to participate in these programs, physicians and pharmacists are asked to sign up online. In most states, pharmacists enter a record of which patients received what drugs on a regular basis – usually weekly or monthly. Only a handful of states are using real-time recording programs.

When patients appear to be filling a suspicious number of prescriptions, some states will advise the prescribing physician. However, fewer than half of states advise doctors in this way and only 20 percent of them advise authorities like police or medical and professional boards. Medical and professional boards hold licensing power and are in a position to investigate or warn doctors or pharmacists when irregularities appear. Doing this helps doctors identify patients who are actually engaging in doctor shopping in order to collect prescriptions. It also identifies pharmacies which are lax in preventing abuse. The lure of profit has led to the rise of pill mills, or pharmacies which are complicit in the prescription drug trade.

Prescription drug monitoring programs hold great promise in the fight against prescription drug abuse, but adjustments to methods are needed. For starters, doctors should be required to sign up. There should be standardized reporting formats for all states. There likewise needs to be a standardization of what constitutes a warning level of prescribing and information ought to be shared freely between states so that abusing patients cannot avoid detection by crossing a state line. Finally, all states should be encouraged to move toward real-time reporting for pharmacies so that suspicious behavior can be detected immediately rather than one month after the fact.