Prescription databases mark the latest round of efforts by state governments to stem the tide of opioid addiction, but doctors worry that unintended consequences may undermine their effectiveness.
Only Missouri lacks some type of prescription monitoring database, according to an article in the Wall Street Journal, which notes that the state programs have shifted their focus from patients who seek drugs from multiple physicians to the prescribing patterns of individual doctors. Other efforts to reduce opioid prescriptions have included FDA warnings and revised CDC guidelines. Some combination of these factors led to a 30 percent drop in prescribing rates for opioids from 2001 through 2010, according to a June study from Health Affairs.
The next step in the evolution of prescription monitoring appears to be integrating the state-by-state data, according to the Wall Street Journal. The article cites efforts underway at the federal and state levels, including the PMP InterConnect program run by the National Association of Boards of Pharmacy, which Massachusetts recently joined. Such programs give doctors a view into patients’ prescription histories across state lines, when they previously only had access to in-state data.
Use of monitoring programs to police doctors’ habits has raised alarms from some doctors, as well as the American Civil Liberties Union (ACLU), according to the article. Some critics are concerned that providers may deal with the potential for receiving a government reprimand by “pushing pain patients out of their practice,” says Christopher Ringwalt, a senior research scientist at the University of North Carolina Injury Prevention Research Center. The ACLU also sees a chilling effect on the doctor-patient relationship, where the stigma attached to painkiller prescriptions results in patients becoming less comfortable seeking those medications for legitimate reasons. This creates additional difficulty as doctors attempt to balance sensible prescribing habits with doing the best for their patients.