Prescription Monitoring Programs

While I was writing this article,legislators in Florida werestruggling once again to tryto pass a bill that would create aPrescription Monitoring Program (PMP)to provide health care professionals andlaw enforcement with a database ofcontrolled substances prescribed intheir state. The Florida Office of DrugControl indicates that 6 people a day diein Florida from prescription drug abuse.

My home state, Ohio, is about toimplement a PMP sometime this summer.In addition to tracking controlledsubstances, the Ohio Board ofPharmacy will also have the ability tocollect data on noncontrolled substancesthat are being abused, likecarisoprodol and tramadol. This is along-awaited program for Ohio's lawenforcement and health professionalswho deal with the issues of prescriptiondrug abuse every day.

PMPs are the most effective way forall of us to deal with doctor shoppersand health care fraud. A few of the currentPMPs either do not allow for lawenforcement access or require subpoenasto access the information.Although the need for prescribers anddispensers to access this informationis without question, making it difficultor impossible for law enforcement togain the information for legitimateinvestigations is counterproductive.

Since a considerable amount of doctorshopping involves health carefraud, these investigations aided by thePMPs will ultimately reduce this costlycrime that contributes to our ownhealth care costs. Would state-fundedhealth care, like Medicaid and workers' compensation programs, save enoughmoney to fund these PMPs in moststates and save lives?

If 6 people a day die in Florida fromprescription drug abuse, how many ofthose could potentially be saved byhealth care professionals and lawenforcement being able to access aPMP? If we saved 1 a day, wouldn'tthat be plenty of reason for states toadopt these programs and then pursuethis problem aggressively by giving lawenforcement easy access? Thoseaddicts that are accessing these drugswould be put in the justice system andgiven a chance to either spend time injail or make a serious attempt at rehabilitation.

Countless drug addicts' lives havebeen saved by being forced into the justicesystem in this country and finallyfacing their life-threatening issues.Formal drug courts can be an excellentadvocate for these people, as they monitoraddicts much more closely thanconventional courts and often allow fortheir criminal record to be expungedwhen first-time offenders successfullycomplete their rehabilitation.

So, PMPs help health care professionalsmake better decisions onpatient care, law enforcement canaddress doctor shopping, addicts mayaddress their problem, health careexpenses will be lowered, and lives willlikely be saved.

So, why is it that most states still donot have this program in place, andFlorida is once again struggling with tryingto get this measure passed? Someblame privacy issues; others point a fingerat pharmaceutical companies thatlobby against these programs, citing thefear of reduced prescribing of controlledsubstances for legitimate patients.

The truth, however, is that the HealthInsurance Portability and AccountabilityAct has exclusions for drug diversion,and OxyContin maker Purdue Pharmahas provided money and resources inan attempt to allow PMPs to be formedand prescription drug abuse educationto be funded, with access for lawenforcement to the database.

I hope that other states take a cuefrom the current PMP programs runningand develop their own databasesthat are available to health care professionalsand law enforcement. Lawenforcement then needs to capitalizeon this opportunity to make a seriousdent in prescription drug abuse andhealth care fraud in their respectivestates.

John Burke, commander ofthe Warren County, Ohio,drug task force and retiredcommander of the CincinnatiPolice PharmaceuticalDiversion Squad, isa 38-year veteran of lawenforcement. Cmdr Burkealso is the current presidentof the National Association of Drug DiversionInvestigators. For information, he can bereached by e-mail at burke@choice.net, viathe Web site www.rxdiversion.com, or byphone at 513-336-0070.