National Effects of Prescription Drug Monitoring Programs
Posted on March 5, 2010As of 2008, the U.S. Center for Disease Control and Prevention (CDC) declared that drug overdose had become the second leading cause of unintentional death, just behind motor vehicle fatalities. However, more recent evidence is showing an exponential surge in drug overdose deaths, caused specifically by prescription drugs. Prescription medications are still considered by some to be non-toxic or harmless, as opposed to illicit drugs, which are universally identified as being deadly. Prescription medication, however, can be just as toxic, and is accessible to anyone of any age who can purchase them legally with a prescription, find them in a parent’s medicine cabinet, or gain them by means of prescription forgery or diversion—also known as “doctor shopping.”
Health officials from Ohio and Georgia are calling the latest legal drug overdose statistics evidence of a rising epidemic. Across the board, this epidemic is surging to the top of many state mortality rates. In Ohio and Georgia, prescription drug overdoses have become the leading cause of unintentional death, surpassing motor vehicle fatalities. In Ohio’s Montgomery County alone, the death toll is greater than the national average (also 2.4 times greater than the state’s average). The county also has highest rate of prescription drug overdose-related deaths in the state.
Contrary to general perceptions, the group most affected by drug overdoses is not adolescents, or socioeconomic or ethnic minorities, but middle-aged white males. Since 2006, this trend has been influenced by the accessibility of prescription medications, especially to those with reliable health care benefits. The most common type of prescription drug related to overdose deaths is opioids, which include narcotic pain relievers such as Vicodin and OxyContin, or compounds like methadone.
In Georgia, both the Chief Medical Examiner and the Georgia Bureau of Investigation have acknowledged prescription drug poisoning as the leading cause of death. In 2008, the GBI confirmed that 85 percent of the year’s overdose deaths were caused by prescription drug poisoning. The problem may be spurred by misinformation about these anxiety or pain relieving medication, such as dosage control or dependency. The misconception that medicine is “safe” belies the seriousness of these drugs’ toxicity. When adults treat prescription medications as being non-habit-forming drugs or as general remedies for common ailments, the message gets passed right along to adolescents. With prescription drug overdose deaths superseding overdose deaths caused by methamphetamine, heroin, and cocaine combined, legal drug abuse has become a serious national health problem. More than 9 million Americans are believed to be prescription drug abusers today.
The upsurge in these mortality figures may be influenced by such factors as pharmacists receiving too many prescriptions to fill at once and missing the opportunity to inform their patients of proper usage of these medications. In other cases, prescription drugs are purchased by illegal means. Some prescription drug abusers will go as far as “doctor shopping” to gain multiple prescriptions for drugs and then take the prescriptions to various pharmacies, or even stealing others’ identities to gain even more prescriptions.
As many as 34 states, with 7 more having enacted legislation, run a statewide prescription drug monitoring program (PDMP or PMP) to help keep track of how many prescriptions are filled for each individual and how many locations challenge diversion efforts among the public. The purpose of these databases is to allow doctors to instantly review their patients’ prescription drug histories before writing a prescription. PDMPs give all health professionals, law enforcement agencies, and medical profession regulatory boards immediate access to patients’ controlled-substance records to help combat the epidemic. Georgia is currently not one of the states running a mandatory PDMP; for the last two years, the program has been proposed by its state legislature, but the bill has failed to pass as of yet.
California introduced its own secure statewide PDMP database, known as the Controlled Substance Utilization Review and Evaluation System (CURES), in September 2009. CURES has become the largest and most effective Internet-based prescription monitoring database that other states have now emulated or are in the process of adopting. California doctors can discern whether their patients legitimately require pain medication or are scamming them to help feed an addiction. CURES seeks to diminish drug trafficking and abuse among prescription drug dealers and doctor shoppers, reduce legal drug overdose and injury, and decrease the number of emergency room visits and the cost to healthcare providers for prescription drug-related injuries.
Prescription drug abuse has not only become an epidemic to the American population’s health, but also its healthcare system. Prescription drug abuse and misuse is believed to cost the state and health insurers millions of dollars per year. CURES has effectively reprimanded such severe cases of doctor shopping as Frankie Greer, a California woman who gained about 8,000 oxycodone tablets, OxyContin pills, and hydrocodone tablets by visiting 183 doctors at hospital emergency rooms within a one-year period. Arrests have also been made against doctors who supply drug addicts with prescriptions, and drug seekers who have stolen doctors’ identities or their patients’ to write phony prescriptions for themselves.
Missouri, like Georgia, does not have a PDMP, and lacks not only the ability to regulate patient prescription requests but also the authority to penalize prescription drug abuse. Law enforcement has no way of reprimanding individuals who seek multiple doctors for multiple prescriptions, even if the activity is illegitimate—it remains legal. Both adults and teens are doctor shopping, and adolescents are holding what is known as “pharm parties,” where guests bring whatever pills they obtained and put them in a bowl for partygoers to reach into and wash down with alcohol. Because prescription pills are likely to be found in every medicine cabinet in the American home, the problem seems inexorable.
The Alliance of States with Prescription Monitoring Programs is a nonprofit organization that provides state and federal agencies and individuals with multiple resources for diffusing prescription drug abuse, misuse, and diversion. The Alliance continually tracks the effectiveness of these PDMPs as well as funding, legislation, organization, research, and data related to these programs. To learn more, visit the Alliance’s website at http://www.pmpalliance.org/.
