Prescription Drug Monitoring Programs (PDMPs) are an essential tool for combatting the inappropriate use of prescription drugs. New York has put in place legislation that may serve as a model for how best to design and implement such a program.
The bill calls for mandatory electronic communication of prescriptions between doctors and pharmacies within three years, real time tracking of prescriptions, and required record checks before doctors write new scripts for certain medications, including opioids.
Of course, state level efforts can only have so much impact. Doctor shopping across borders is becoming increasingly common and right now, no single database contains sufficient information to help prevent inappropriate prescriptions on an interstate basis. I understand there is some nascent movement toward establishing such a database, but my quick research didn't yield anything substantial.
And congrats to New Hampshire for finally getting its act together. NH is the 49th state to establish a PDMP program. The "Live Free of Die" crowd certainly fought against it, even winning a provision that data would be deleted after 6 months (unless abuse is expected). We'll take what we can get.
The lone hold out? Missouri. The "Show Me" state needs to show us they're serious about prescription drug abuse. Might be an uphill battle, though. Here's a quote from Missouri State Senator Rob Shaaf (R-St. Joseph), a family physician, after the passage of a PDMP bill in March of this year (which appears to have stalled in committee back in May): "Letting the government have your very personal and sensitive medical information on a government database, it's just wrong and Big Brother shouldn't have that effect on our lives... this is liberty versus safety."
Yeah... drug addicts should be free to doctor shop as much as they wish without fear of detection or consequence. And drug seekers throughout the midwest should feel equally free to flood into Missouri seeking prescription drugs. Not exactly enlightened public policy, but so what if the preservation of liberty makes Missouri the nation's capital for prescription drug abuse?
Liberty has its bounds, Dr. Schaaf, and you're on the wrong side of this one.
Michael
On Twitter @PRIUM1
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