Prescription Monitoring Programs

Most states now have electronic databases containing patient information, available to physicians, of all prescribed controlled substances, the date they were picked up at the pharmacy, and the prescribing physicians. The federal government has strongly encouraged states to form these databases to prevent patients from “doctor shopping.” The idea is that every physician will check this database before writing prescriptions for pain pills or other controlled substances, to make sure the patient in question isn’t getting pain pills from another doctor.

These programs have been incredibly helpful to me, since I treat people with addiction. Many of the patients are addicted to prescription pain pills. If a patient gets prescription opioids while I am treating them with methadone or buprenorhpine, my first step is usually to talk with them about what’s happening. If the patient is willing to give me permission to talk with the other doctor, and stop getting other opioids, the patient can usually stay in treatment with me. But if this happens more than once, I may decide it’s no longer appropriate to prescribe methadone or buprenorphine.

I’ve had some patients say that they don’t think it’s any of my business what their other prescriptions are. But I tell them that it’s only my business because they have asked me to prescribe medication to treat their addiction.

Most patients don’t fill any prescriptions without letting me know what they’re getting, but there are always a few patients who have mixed feelings about stopping their prescription opioids. Some patients are concerned that if I talk with their other doctor, they won’t be able to get more opioids from that doctor. I tell them that’s actually what I’m hoping for. It’s important to burn the bridges back to active addiction.

For now, state databases don’t connect with each other. Soon, a national prescription monitoring database may be accessible to physicians so that only one sources needs to be consulted, rather than multiple databases, for doctors who live near state borders.

I know the North Carolina prescription monitoring database has saved lives. Many people worry about their privacy with such a system, and I agree it’s a real concern, but hopefully the databases have adequate security systems to minimize risk.

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3 responses to this post.

  1. I believe it is a much needed system. Generally those who oppose such a system are the ones abusing drugs. I know I was opposed to it when I was active in addiction.

    Reply

  2. Posted by christy on July 20, 2010 at 10:37 am

    Great story

    Reply

  3. Thanks for this, very enlightening. I work with prescription monitoring programs and would very much like to learn more about your experience with them.

    Reply

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