Fighting Prescription Drug Abuse With A National Online Database

After watching the events of this past week unfold with the untimely death of Whitney Houston, and being reminded of the fate of Michael Jackson, my mind shifts to the ever present problem of prescription drug abuse.

As a practicing ER physician, I have encountered many patients who have come to the hospital requesting prescriptions for a number of sedatives and narcotics alike. Some patients may have a valid reason that may require such a medication. However, there are also a number of patients who may be “drug seeking” and have visited other hospitals, clinics or physicians’ offices prior to coming to the emergency department, often requesting duplicate prescriptions or who were turned down by another medical provider.

It would be quite valuable for a physician to have knowledge of previous visits to clinics and hospitals as well as prescriptions that a patient may have received in a real-time fashion–not only as a safety-net, but also as a way to deter the ever growing problem of prescription drug abuse by “doctor shopping”.

The state of California currently has in place a voluntary prescription drug monitoring program (PDMP), whereby providers can readily access real- time information about recent prescriptions that a patient received. The PDMP enables both prescribers and pharmacists to utilize their professional expertise to evaluate their patients care and assist those patients who may be abusing controlled substances. The California Attorney General’s Office strongly feels that if doctors and pharmacies have access to a patient’s controlled substance history information in a real time fashion, it can assist them to make better prescribing decisions and cut down on prescription drug abuse.

California’s database, known as the Controlled Substance Utilization Review and Evaluation System, “CURES”, has over 100 million entries of controlled substance drugs that have been dispensed to date in California. According to the DOJ website for the state of California, the CURES program responds annually to more that 60,000 requests from medical providers and pharmacists. In many ways, the online PDMP system will likely make it much easier for authorized prescribers and pharmacists to rapidly review controlled substance information in an effort to identify and deter drug abuse.

Creating a national online database which is mandated, as opposed to voluntary, would be a more realistic step in the right direction. Those physicians who inappropriately prescribe would be forced to reexamine their prescribing behaviors, which ultimately could lead to corrective action.

As Dr. Drew Pinsky recently stated, the “special care” that certain physicians provide for drug seeking celebrity patients is certainly “substandard care”. I applaud him in his stance against physicians who continue to practice in this fashion. The deaths of both Whitney Houston and Michael Jackson should serve as a reminder of this ongoing critical problem in the US.

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