Several states have had prescription drug monitoring programs for decades, but the databases designed to reduce doctor shopping have undergone drastic changes since the opioid epidemic began in the early 2000s.
Today, 49 states have operational prescription drug monitoring programs and the District of Columbia has passed legislation approving the development of a PDMP. However, many databases are criticized as being ineffective because they do not require all prescribers to submit data.
In response, states have enacted legislation to strengthen the systems. The Minnesota legislature passed laws requiring all doctors, pharmacists and dentists to have credentials to log into the system. But the bill does not require prescribers to use the system before prescribing controlled substances.
State officials hope the small step will encourage more doctors to use the program. As of March less than a third of Minnesota doctors had created accounts to sign into it, according to MPR News.
“It doesn’t require [doctors] to use it every time that they want to do a prescription, but as long as they have that log-in, we at least understand that they know how to get into it, and how easy it is,” state Rep. Dave Baker told MPR News.
In February, California upgraded its PDMP to be more user friendly. Technical issues, lengthy processes and a difficult registration system plagued the old version.
The upgrades haven’t gone as smoothly in other states. Almost two years ago, the Pennsylvania legislature passed bills approving a revamped PDMP. Former Gov. Tom Corbett signed the bills into law in October 2014. However, prolonged budget delays and a lack of other resources have prevented the program from being implemented.
“It probably sounds like it would be easy to do, but it’s far more sophisticated than what most folks realize it might be,” Pennsylvania Sen. Jay Costa told WPXI News.
The U.S. House of Representatives passed a package of bills designed to reduce prescription drug abuse on May 13. One of the bills, the Opioid Abuse Reduction Act (H.R. 5046) sponsored by U.S. Rep. James Sensenbrenner (R – WI), would approve $103 million in grants for state monitoring programs.
It would also approve funding for programs that cross state lines thanks to a bipartisan amendment introduced by U.S. Reps. Buddy Carter (R – GA) and Mark DeSaulnier (D – CA).
“To increase the effectiveness of these programs, states must be able to work together,” Carter told East County Today. “Unfortunately, today, most states are not interoperable and that is why this amendment is so important. States should have every opportunity to share information effectively and efficiently about patients and the patterns that occur with interstate prescription drug trafficking.”
New Jersey’s PDMP is one of the largest multistate programs in the country. Since the beginning of 2016, it has been sharing data with Minnesota, Delaware, Connecticut, Rhode Island and Virginia.
Gov. Chris Christie announced the state of New York had agreed to join the program in April.
“Partnering with New York adds tremendous strength to the PMP’s ability to track suspicious signs of prescription drugs and other suspicious behaviors,” Christie told CBS New York.
The governor also said he hoped Florida would join the program soon.
Missouri is the only state in the country without a prescription drug monitoring program. Most experts and health officials believe PDMPs have the potential to be among the most effective tools for reducing prescription drug abuse.
However, Missouri bill H.B. 1892, which would have enacted a statewide PDMP, failed to gain traction when the legislature closed May 13. The bill died when the legislative session ended.
The bill’s opponents said the prescription databases infringed on personal liberty and could be breached. Bill sponsor Sen. Dave Schatz told the Kansas City Star he had done everything he could to address the concerns of the bill’s opponents.
Former state Rep. Sam Page had sponsored five bills to enact PDMPs before leaving office. Each of them failed because of privacy concerns.
“The only people [who] should have access to personal identifiable information of the patient will be the treating physician and the pharmacist,” Page told the St. Louis Post-Dispatch. “It’s just like any other electronic medical record. The only difference is that it communicates with other physicians.”
In February, Page sponsored a St. Louis County bill to implement a monitoring program for the county. It was approved by the city council and became part of the county code in March. He’s hoping the program’s success will inspire state lawmakers to follow national trends and develop a statewide database.