Government Technology

National Prescription Drug Database Slowly Becoming Reality

May 11, 2010 By

They're often called doctor shoppers, border hoppers, pharm-aholics and even hit-and-runners. They count on states' lack of communication and exploit professionals whose job is to heal, hurting themselves and feeding others' addictions through such feats.

They're prescription painkiller addicts and, like other drug addicts, often go to extreme measures to get their fix. It's not a new problem, just one that's recently become more visible with high-profile celebrity deaths being caused by prescription pill overdoses.

"The least fun part of my job is managing medications," said Connecticut-based pain physician Dr. David Kloth, who referred to Michael Jackson -- formerly the King of Pop -- as the King of Drug Popping. "You are suspicious of everybody -- it's sad, but everyone is painted with the same broad brush."

It may be sad, but it's what doctors face every day. Pain pill-related deaths have risen significantly over the years, with overdose deaths becoming the second leading cause of unintentional injury death in 2002, just behind motor-vehicle injuries, according to a Centers for Disease Control and Prevention (CDC) study. This increased death rate stems from prescription drugs known as opioid analgesics -- powerful, addictive drugs like OxyContin and Vicodin that produce heroin-like effects -- that were increasingly prescribed in the 1990s to treat pain.

"Their potential for misuse was underestimated, and opioid analgesics quickly became the most popular category of abused drugs," the CDC report stated.

In an attempt to track patients' prescriptions and prevent double dipping between doctors -- and states - many states have created prescription drug monitoring programs through federal funding sources. As it stands, 41 states have passed laws to create some type of program, but some states with multiple nearby neighbors -- like Maryland, Arkansas and Nebraska -- don't have any such law or bills pending.

"You need to know this information when you have a patient you're concerned about," Kloth said, adding that prescription drug abuse can often contribute to social ills such as divorce, child abuse and neglect. "The stories are endless."

Under the National All Schedules Prescription Electronic Reporting Act (NASPER) -- signed by President George W. Bush in 2005 -- more than $50 million has been given to states to enact programs that allow doctors and other authorized users, like police, to access patient records. Though the NASPER legislation called for $50 million in funding, to date it has received $2 million as a result of denials by the Appropriations Committee.

The law's aim is to have a coordinated national system that monitors an array of controlled substances -- all those in Schedules II, III and IV (e.g., cocaine and anabolic steroids), as defined by the U.S. Drug Enforcement Administration and the U.S. Food and Drug Administration. It permits states to exchange sensitive data with each other to deal with border hoppers, doctor shoppers and the like.

"Patients moving from one jurisdiction to another (as in cases involving Virginia, the District of Columbia and Maryland) will typically be able to obtain multiple prescriptions by merely crossing state lines," a NASPER fact sheet stated. "The conscious and more prevalent unconscious misuse of Schedule II, II and IV controlled substances, are a national problem that cannot be effectively addressed on a state-by-state basis."

But states are making progress toward implementing such monitoring programs, said Joanee Quirk, who runs the Nevada Prescription Drug Monitoring Program. "[States] have a common bond, but we all run our systems a bit differently," she said.

Those differences can sometimes create strife between states, she said. For example, unlike many other states, Vermont doesn't allow outside law enforcement agencies to access its system,

NASPER proponents are preparing to file for reauthorization of the bill with Congress, the effects

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mapa    |    Commented May 12, 2010

A more accurate account would be:... "increasingly prescribed since the 1990s to treat pain" and seeing the problem skyrocket in the first decade of the 2000s to uncharted heights!

mapa    |    Commented May 12, 2010

A more accurate account would be:... "increasingly prescribed since the 1990s to treat pain" and seeing the problem skyrocket in the first decade of the 2000s to uncharted heights!

mapa    |    Commented May 12, 2010

A more accurate account would be:... "increasingly prescribed since the 1990s to treat pain" and seeing the problem skyrocket in the first decade of the 2000s to uncharted heights!

Linda    |    Commented October 2, 2012

What you are overlooking is that people like MICHAEL JACKSON have enough MONEY TO BUY THE DOCTORS AND THE DRUGS..yet you are stopping people who really need the medication to have a better QUALITY OF LIFE. I have to fight for anything to get the medication to live. I shattered 2 part of my spine..for 16 years I dealt with the pain. Now I am older and the pain is more than I can handle. My Neurosurgeon recommended the pain pump. I barely walk the pain is so great, but I have had to go through the pain clinic for the past year doing everything, to no avail, except what my neurosurgeon recommended. Why should I have to go through this pain and so long to get the help my neurosurgeon KNOWS I NEED. He did my surgeries, he knows I am not faking it...WHAT IS WRONG WITH YOU PEOPLE!!!WHY DON'T I DESERVE TO GET THE HELP I NEED TO FUNCTION?

Karen Stinnett    |    Commented January 17, 2013

I understand what Linda is experiencing. A friend of mine is going through the same thing. He has had two back surgeries and countless epiderals to try to alleviate the pain. Yet, when he asks for pain meds...the docs treat him like a "pill head". Doctors...PLEASE NOTE that there are people out there who are NOT "pill heads" and REALLY NEED this pain medication just to lead a half-way normal life. Without some type of pain medication, people like Linda...and my friend are in sheer MISERY!!!! My friend has even often attributed his religion and his strong belief in God as his only savior from just ending it all. It is a shame that people who need pain medicine have to even consider suicide when there are medications out there that can help them if they would just be given access to them!

Nitish Varshney    |    Commented March 6, 2013

Hi, I am looking to develop a new algorithm which can be used to detect frauds done by Doctors by prescribing pointless tests. According to a report 18% of medical frauds are done in this way. Using such a mechanism doctor is able to prescribe a test to patient that is not related to patients diagnosis and / or symptoms. But I am not able to get data for testing my algorithm and further improvements in it. Could you please guide me for the same.

Michele    |    Commented April 4, 2013

I believe in using the database to stop pill shoppers from using multiple doctors. BUT the real hardship issue is that now today doctors are so afraid to give out medication, that they take your money, give you just enough medication to stay under DEA;s radar, and could care less that you aren't getting enough medication to free you of your pain. This leads to people unable to work or function at home making them suicidal just cause they are in constant pain. And why wouldn't they contemplate it? Doctors just don't care anymore, they just want to make their $300 visits.

Eric K    |    Commented May 29, 2013

The government needs to own up to the fact that it is responsible for doctor's overprescribing pain meds. What is not mentioned in the article is that a patient's report of "pain" became a "vital sign" according to many medical regulating bodies. Further, doctors were told that they HAVE to address that patient's report of "pain". Since pain is subjective and no doctor yet has a way to determine if a report of pain is real or not they treated as they were "ordered" to do by various regulatory authorities. What was created less than 10 years later is the biggest opioid abuse problem the US has ever seen. Tell government to stay out of healthcare period. Guess what? As a doctor I am now told to treat pain, it is a must, but don't give medications for it or you could lose your license. You choose. Thanks!

SB    |    Commented July 18, 2013

I cannot even comprehend going to several doctors to get multiple prescriptions. How does the person in the article afford to see 35 doctors? Does he have insurance? If so, why does his insurance company allow this? Mine won't refill a Rx even one day 'early' even if I am going out of town on vacation! If this example person doesn't have insurance, how does he pay for Rx at 25 different pharmacies? And Erik K is quite right. Pain is subjective and the doctor can only report the patient's "level of pain on a scale of 1-10" which is the most ridiculous assessment tool ever! For me, as a cancer patient with bone mets pain and muscle spasms/nerve pain, a "10" being the "worst pain you've ever experienced" is very different than a "10" for someone else who has never had anything other than a pulled hamstring. I wouldn't wish the type/amount of pain I experience on anyone, however.... suppose these lawmakers who are attempting to 'reform' healthcare were required to undergo some type of procedure whereby they would have to experience varying levels of pain, including chronic, debilitating pain for just one week....

SB    |    Commented July 18, 2013

IF ONLY WE COULD RETURN TO THE DAYS ... 1. when "Privacy" had real meaning. 2. when a patient's medical issues were just between the patient and their doctors.... 3. when the patient could get his/her own records more easily than could everyone else. 4. before advertisements instructed patients to "ask your doctor if ____ is right for you", followed by a litany of side effects which take up 75% of the ad. 5. before pharmaceutical companies ran the economy!

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