California bill seeks drug-database upgrade

California wants to beef up its prescription-monitoring program, and Pennsylvania wants to set one up to help physicians and pharmacists crack down on "doctor shopping" for narcotic painkillers.

Meanwhile, efforts to create a prescription-monitoring program in Missouri--the only state without legislation creating one--are making a comeback, though a lawmaker leading opposition against it has introduced a bill calling for putting the issue to a popular vote.

Two California lawmakers have introduced legislation to upgrade its database, known as CURES, to flag doctors with questionable prescribing habits. To date, the state has been ineffective in curbing over-prescribing and that state officials say they don't have the resources to use the system effectively.

The California Department of Justice has undergone $70 million in budget cuts during the past two years and Attorney General Kamala Harris has described CURES as "on life support." It operates with a $400,000 annual budget and one full-time employee from Harris' office. She has not used CURES to curb over-prescribing, and reportedly has said that even if questionable practices were flagged, the state's Department of Justice lacks resources to follow up on leads.

The new bill calls for taxes and fees to pay for the estimated $9.6 million upgrade, according to the Los Angeles Times.

In Pennsylvania, House Bill 317 would establish the Pennsylvania Accountability Monitoring System, to help physicians and pharmacists flag questionable prescriptions. That bill has moved out of committee and is scheduled for a vote March 12 by the full House, where it appears to have broad support, according to the Washington (Pa.) Observer-Reporter.

Missouri remains the only state without such a program, according to the Alliance of States with Prescription Monitoring Programs. (It describes Pennsylvania's current system as one that can be queried only by law enforcement.) Wisconsin's program kicks off June 1, according to Wisconsin Public Radio. State Senator Rob Schaaf (R), a physician in St. Joseph, who successfully led a filibuster last year against legislation to establish such a program, cites privacy concerns in his opposition.

"If the people of Missouri want to have a government-run database, accessible by thousands of people with sensitive information on it, they should be free to do so. But I don't believe it's the place of the legislature to do this to them," he said, according to KCUR.

Though most states have such programs, not all of them are taking full advantage of them. In Mississippi, for instance, two-thirds of physicians don't use their system, which is not mandatory.

To learn more:
- here's the Times article
- read the Observer-Reporter story
- find the Alliance of States with Prescription Monitoring Programs status map
- here's the KCUR report
- check out the Wisconsin Public Radio piece

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