A bill before the US House and Senate would have required physicians and pharmacists to check state databases before prescribing or dispensing opioids.
All available research shows this is the single most effective step to reduce opioid abuse and kill fewer people.
Now, thanks to “doctors and pharmacists groups”, that requirement has been stripped from the bill. What’s left is some – but nowhere near enough – money for treatment and the hope that, against all evidence to the contrary, docs who are writing the scripts that are causing the opioid disaster will take the time to check the databases before they write the script.
Not going to happen.
I am sympathetic to the claim that mandatory Prescription Drug Monitoring Program (PDMP) checking can be time-consuming. States have to do a better job of figuring out how to streamline the process while protecting patient confidentiality – and many have done so. Moreover, the four states with mandatory PDMPs have figured it out, and it is working pretty well.
I am a whole lot less sympathetic to the argument that somehow a moment or two of a doctor’s or pharmacist’s time is too much to ask, for the simple reason that these medical professionals’ failure to properly prescribe and dispense opioids is the proximal cause of the opioid public health disaster.
Pretty much every independent research organization studying the issue has recommended mandatory PDMP checking. Here’s one.
More bluntly, that behavior is killing people, and the lobbying to strip mandatory use of PDMPs shows that’s not that big a deal.
Kentucky, New York, Ohio, and Tennessee all mandate prescribers access PDMPs – and all have seen dramatic reductions in doctor shopping and opioid script volume.
There’s a wealth of supporting data here. Briefly, here’s what mandatory PDMP use does.
- after Ohio ER docs checked the PDMP, they changed their treatment plan for 41% of patients; 61% had fewer or no opioids prescribed, 39% had more. And doctor shopping dropped by over 2/3.
- In Tennessee, doctor shopping dropped by 50% and the volume of opioid scripts decreased by almost half a million scripts.
- Kentucky doctor shopping was cut in half, 30% fewer patients received the “holy trinity” drug cocktail, and benzo and opioid scripts dropped significantly.
- in New York, doctor shopping was cut by 90%, and treatment admissions rose by 20%.
After spending a fruitless hour searching the web for an actual policy statement or testimony regarding mandatory PDMP use by the AMA, my conclusion is the giant medical society wants it both ways.
They don’t want their members to have to check PDMPs, but they don’t want to be public about that opposition.
What does this mean for you?
Refusing to support mandatory PDMP is unconscionable. At some point an enterprising class-action firm is going to figure out how to make a shipload of money off the intransigence of “doctors and pharmacists groups.”