/publications/issue/2006/2006-06/2006-06-5643

Prescription Monitoring Programs

Author: Cmdr John Burke

While I was writing this article, legislators in Florida were struggling once again to try to pass a bill that would create a Prescription Monitoring Program (PMP) to provide health care professionals and law enforcement with a database of controlled substances prescribed in their state. The Florida Office of Drug Control indicates that 6 people a day die in Florida from prescription drug abuse.

My home state, Ohio, is about to implement a PMP sometime this summer. In addition to tracking controlled substances, the Ohio Board of Pharmacy will also have the ability to collect data on noncontrolled substances that are being abused, like carisoprodol and tramadol. This is a long-awaited program for Ohio's law enforcement and health professionals who deal with the issues of prescription drug abuse every day.

PMPs are the most effective way for all of us to deal with doctor shoppers and health care fraud. A few of the current PMPs either do not allow for law enforcement access or require subpoenas to access the information. Although the need for prescribers and dispensers to access this information is without question, making it difficult or impossible for law enforcement to gain the information for legitimate investigations is counterproductive.

Since a considerable amount of doctor shopping involves health care fraud, these investigations aided by the PMPs will ultimately reduce this costly crime that contributes to our own health care costs. Would state-funded health care, like Medicaid and workers' compensation programs, save enough money to fund these PMPs in most states and save lives?

If 6 people a day die in Florida from prescription drug abuse, how many of those could potentially be saved by health care professionals and law enforcement being able to access a PMP? If we saved 1 a day, wouldn't that be plenty of reason for states to adopt these programs and then pursue this problem aggressively by giving law enforcement easy access? Those addicts that are accessing these drugs would be put in the justice system and given a chance to either spend time in jail or make a serious attempt at rehabilitation.

Countless drug addicts' lives have been saved by being forced into the justice system in this country and finally facing their life-threatening issues. Formal drug courts can be an excellent advocate for these people, as they monitor addicts much more closely than conventional courts and often allow for their criminal record to be expunged when first-time offenders successfully complete their rehabilitation.

So, PMPs help health care professionals make better decisions on patient care, law enforcement can address doctor shopping, addicts may address their problem, health care expenses will be lowered, and lives will likely be saved.

So, why is it that most states still do not have this program in place, and Florida is once again struggling with trying to get this measure passed? Some blame privacy issues; others point a finger at pharmaceutical companies that lobby against these programs, citing the fear of reduced prescribing of controlled substances for legitimate patients.

The truth, however, is that the Health Insurance Portability and Accountability Act has exclusions for drug diversion, and OxyContin maker Purdue Pharma has provided money and resources in an attempt to allow PMPs to be formed and prescription drug abuse education to be funded, with access for law enforcement to the database.

I hope that other states take a cue from the current PMP programs running and develop their own databases that are available to health care professionals and law enforcement. Law enforcement then needs to capitalize on this opportunity to make a serious dent in prescription drug abuse and health care fraud in their respective states.

John Burke, commander of the Warren County, Ohio, drug task force and retired commander of the Cincinnati Police Pharmaceutical Diversion Squad, is a 38-year veteran of law enforcement. Cmdr Burke also is the current president of the National Association of Drug Diversion Investigators. For information, he can be reached by e-mail at burke@choice.net, via the Web site www.rxdiversion.com, or by phone at 513-336-0070.