Opioid Mandatory Monitoring

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Requiring Doctors to use Prescription Drug Monitoring Systems

With the opioid crisis reaching epidemic proportions, most states are now requiring doctors to use prescription drug monitoring systems for their patients, according to a recent report in the Washington Post.

At least 39 states now require that doctors check these databases to see what other medicines their patients are taking before prescribing highly addictive painkillers such as Percocet, Vicodin and OxyContin. Pharmacies also must consult these databases before dispensing controlled substances to their customers.

North Carolina is among states that now require doctors and other health care professions to use prescription drug monitoring systems after the Strengthen Opioid Misuse Prevention Act became law in 2018. But implementation of the so-called STOP Act, particularly the usage of prescription drug monitoring systems, is still ongoing.

More than 63,000 people died from drug overdoses in 2016, a number that has been increasing since 1999, according to the Centers for Disease Control and Prevention. More than 15,000 deaths annually are caused by prescription opioid  overdoses.

In North Carolina, more than 12,000 people have died from opioid-related overdoses from 1999 to 2016. There has also been a 40 percent rise in emergency room visits for opioid overdoses in the state, according to data from the N.C. Department of Health and Human Services. North Carolina ERs treated more than 5,700 people for opioid overdoses in 2017, double the number recorded in 2009.

Opioid drugs kill more people in North Carolina than alcohol, cocaine and heroin combined. Drug overdoses result in more deaths in North Carolina than car accidents or firearms.

With the opioid usage and overdoses on the rise, both nationally and statewide, efforts are underway to reduce access to these highly addictive drugs, better monitor prescribers and pharmacies and provide treatment and medical interventions for people who are addicted.

“We saw a big nationwide push this year to make prescription drug monitoring programs mandatory, more comprehensive and effective, and easier to use,” said Chad Zadrazil, a legislative attorney with the National Alliance for Model State Drug Laws told the Washington Post.

Before the mandates, fewer than 35 percent of medical professionals nationwide used the tracking systems to ID patients at risk for addiction, Zadrazil told the Post. Usage rates exceed 90 percent in states with mandates.

North Carolina’s STOP Act requires doctors, dentists and other health care professionals to a check a patient’s history in a Controlled Substance Reporting System (CSRS) prior to prescribing the drugs for the first time. Before prescribing, doctors are supposed to review a patient’s prescription drug history over the last year. They also must review the patient’s records every 90 days while they are on these prescriptions to ensure they’re not getting drugs from other sources. Veterinarians and pharmacists are also required to track prescriptions for controlled substances, including opioids, through the database.

In January 2018, North Carolina connected its Controlled Substances Reporting System to a multi-state prescription-monitoring network that allows doctors and other health care workers to check records in 13 other states. The goal is to widen the network to include all states with prescription-drug monitoring databases.

The state’s prescription drug monitoring networks have existed for years, but few doctors have used them. A WRAL investigation found that the database was used by only 1 in 4 doctors.

In other states where mandates have been in place for longer, there’s evidence of their effectiveness, the Charlotte Observer reports.

In Kentucky, which in 2012 began requiring doctors to check its database, opioid painkiller prescription rates dropped 8.5 percent. In Tennessee, “doctor shopping” decreased by 36 percent after a similar mandate was passed.

The STOP Act and other efforts may already be having an impact in North Carolina. In the fourth quarter of 2017, N.C. hospitals and pharmacies dispensed 20 million fewer opioid pills compared to the same period a year before, according to NCDHSS data. Still, more than 120 million pills were dispensed to patients in the last quarter of 2017.

Because of the lack of oversight and doctors’ tendency to overprescribe these drugs in the past, many people in our state are battling addictions to prescription opioids. Thousands have died or suffered serious injury because of their addictions.

Patients or families who have been affected by prescription drug addiction should know they have legal options. If you have been affected by an accidental prescription drug overdose involving opioids or methadone, we may be able to help. You may have a claim against the physician, pharmacy, hospital, or clinic that prescribed, or fulfilled, these dangerous drugs irresponsibly. Please contact us to see how we can help.

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