In January of last year, Washington State’s prescription monitoring system became the latest measure to curb prescription drug abuse, following in the footsteps of dozens of other states with similar programs in place. The prescription monitoring program is a state-run database that store and distribute prescriptions for federally controlled substances. The program serves physicians, nurse practitioners, dentists, and other prescribers, as well as law-enforcement agencies. Prescription monitoring programs aim to support legitimate medical use of controlled substances while limiting drug abuse and diversion.
Basically, the prescription monitoring system requires that pharmacies send records of every prescription they have dispensed for a controlled substance. Then, once it gets up and running, every future prescription will be logged into the database. Pharmacists, doctors will be able to easily see all controlled substances a patient is getting anywhere in the state, even if the person pays with cash.
Washington State has one of the highest rates of prescription drug abuse in the nation. Washington drug statistics show that prescription drugs account for the most drug-related overdoses in the state. Prescription drug abuse in Washington State is so rampant mainly because of aggressive prescribing practices along with a lack of oversight by the Department of Health. Washington State ranked 4th highest nationally in per-capita for prescribing methadone in 2006 and 11th for oxycodone. Both of these drugs are well known killers.
The prescription monitoring program was put in place in response to troubling numbers of overdoses and deaths from prescription drugs. Proponents say the prescription monitoring program will enable doctors, as well as officials from state programs that pay for health care such as Medicaid and worker’s compensation, to spotlight patients who are “doctor shopping” to get multiple controlled substance prescriptions, and also help cut down on accidental overdose.
Critics say that since the prescription monitoring program is put in place by lawmakers, it is more of a tool of the police than a component of patient safety. They fear that patients with substance abuse or mental health disorders will end up in jail rather than in treatment programs. In addition, unlike programs in some states, Washington’s prescription monitoring program allows licensing boards to use the information to discipline doctors, which may alienate participants. This is especially worrying since Washington State requires doctors who use the prescription monitoring program to pay for it. And prescribers aren’t required to use the system. A national study by the Centers of Disease Control and Prevention found that prescription monitoring programs didn’t cut deaths, overdoses, or consumption. In fact, the prescription monitoring programs may have resulted in patients simply getting more of less-potent painkillers, which may hurt patients with cancer or terminal illness.
The prescription monitoring program in Washington State was authorized by the state’s 2010 pain management law, intended to curtail opiate abuse, which is among the country’s strictest laws regarding the management of chronic non-cancer pain. Doctors who support the prescription monitoring program say that most people don’t purposely overuse medication, and the program allows them to keep patients safe.