Prescription databases to play a vital role in decreasing opioid abuse

In the battles against rampant opioid abuse, physicians have a strong weapon in their arsenal—state prescription databases that detect all prescriptions written for these addictive drugs.

Nearly every state has executed Prescription Drug Monitoring Programs (PDMPs), which record opioid prescribing history of a patient. By leveraging these prescription databases, doctors can access information to make an informed decision about whether sufferers are opioid abusers.

PDMPs gather and share data on prescriptions for controlled substances to flag suspicious prescribing and utilization. Although, not all states need providers to access these kinds of prescription databases prior to writing or filling a prescription.

Researchers have discovered that “must access” PDMPs, which need physicians to consult them before writing prescriptions, primarily reduced opioid misuse in Medicare Part D, based on the review of 3.5 million patient records between the time period of 2007 and 2013. At the same time, their research demonstrated that PDMPs without such compulsory provisions have no effect on curbing opioid abuse.

Regrettably, when provider access isn’t mandatory, data indicates that only small numbers of providers create PDMP logins and actually request patient histories.

“A great instance is Kentucky, which passed a ‘must access’ requirement in the year of 2012 and saw the share of controlled substance prescribers who had developed a login rise from about a third to more than 95%,” claims Colleen Carey, assistant professor of policy analysis and management in the College of Human Ecology at Cornell University.

In accordance to Carey, a healthcare economist, one of the ways states can get providers to start using PDMPs is to pass laws that need physicians to check these databases for their sufferers’ previous prescriptions. She points out that New York has the nation’s toughest laws with those requirements.

“New York (is the) strictest state needing doctors to check the opioid history of ‘every patient, every time,’ which is stronger than any other state,” she claims.

Carey and Thomas Buchmueller, a professor in the Ross School of Business at the institute of University of Michigan, co-authored a paper detailing their findings which are to be released in an upcoming issue of the American Economic Journal: Economic Policy.

“Our results recommend that PDMPs that don’t require provider participation are not effective in decreasing questionable or unsuitable use of prescription opioids,” summarize Carey and Buchmueller. “We do find evidence that ‘must access’ PDMPs have the desired impact of curbing certain kinds of extreme utilization. Particularly, such policies decrease several measures of excessive quantity and shopping behavior. The strongest laws, which cover all ingredients and settings of care and don’t require providers to be suspicious, have larger effects on utilization than weaker laws, but even ‘limited’ and ‘discretionary’ laws lower rates of shopping behavior.”

Doctor shopping is explained as seeing multiple providers to procure prescription medications illicitly. In their research on “must access” PDMPs, Carey and Buchmueller found that Medicare opioid users who got prescriptions from 5 or more physicians—a common indication of doctor shopping—dropped by 8%, while the percentage of those who got opioids from 5 or more pharmacies was reduced by 16%.

Nevertheless, the researchers also analyze that the “passage of a ‘must access’ PDMP might prompt people to cross state lines in search of less-regulated prescribers and pharmacies.”