Prescription monitoring programs

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Legislative Audit Committee. Sections 1 and 2 of the bill clarify that each licensed health-care practitioner must query the prescription drug monitoring program program prior to filling a prescription for every opioid or benzodiazepine. Section 3 requires the group tasked with developing a strategic plan to reduce prescription drug misuse to also make recommendations to the executive director of the department of regulatory agencies concerning balancing the use of the program as a health-care tool with enforcement of the requirements of the program.

Prescription monitoring programs PMP are state-based electronic databases used to track the prescribing of designated controlled substances. The purposes of PMPs are to support access to legitimate medical use of controlled substances as well as to identify, deter or prevent drug abuse and diversion. The purpose of PMPs was to help reduce abuse of and overdose deaths from opioid prescriptions.

Data from the Center for Disease Control indicates that in , there were approximately 42, deaths attributable to opioids, 40 percent of which were from prescription opioids. There are million prescriptions written annually, enough for one bottle for every American adult.

Prescribing is varied and disparate, with the highest prescribing state, Alabama, having three times the number of prescriptions as Hawaii, the lowest prescribing state. The intent of PMPs was to curb all facets of prescription abuse by allowing providers to look up patients, identify high-risk prescription correlates, ensure good prescribing practices, and possibly to assist in helping patients with substance use disorder towards treatment. The concept of the PMP has merit. They may help to identify individuals obtaining controlled substances from several sources, aid in identifying patients receiving multiple prescriptions in a short time frame, or for patients on multiple psychotropic agents.

The PMP has been met with some criticism as well. Several states have demonstrated decreased incidences of death from prescription opiates with the enactment of PMPs. Florida for example, reduced rates of death from oxycodone by 25 percent after implementation of their PMP program.

This would seem promising but most likely is not; deaths from heroin were up eight-fold and those from fentanyl, five-fold in the same time frame. The other issue is how well this very sensitive information is protected. Certainly, access to PMPs could do significant harm to individuals if the information is abused in any way. As with any database, there is a risk of unauthorized access, hacking or misuse. While the intent of the PMP is to curb this crippling epidemic, it still requires scrutiny when it comes to privacy and access.

Prescription monitoring programs do not specifically fall under HIPPA, but the rules still apply with regard to access of information. Most healthcare providers who access the PMP do so legally and to obtain pertinent medical information. They must ensure that the information they obtain is protected and these records should only be accessed for direct patient care.

There are gray areas, however. One such gray area is that scheduled substances used for the treatment of opioid use disorder, such as buprenorphine, when prescribed by a substance abuse treatment center, should not be reported as dictated by the Federal Confidentiality Rule.

Title 42 of the Code of Regulations was instituted to protect individuals seeking substance use treatment from any potentially adverse consequence such as a civil or criminal hearing. What's this? Links with this icon indicate that you are leaving the CDC website. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. You will be subject to the destination website's privacy policy when you follow the link.

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