The Enid News and Eagle, Enid, OK

National and world

February 8, 2014

Abusing prescription drugs

(Continued)

On the offensive

Getting more doctors to participate in the Prescription Monitoring Program is a central element of the state’s prescription drug-abuse offensive.

The PMP is an online database designed to flag patients who seek multiple prescriptions for painkillers and other narcotic drugs from more than one physician.

Oklahoma’s system is considered one of the most advanced in the nation, officials say. All pharmacists are required to enter data for every controlled drug prescription within five minutes of filling it. No other state has a “real-time” reporting requirement like that.

But doctors and other health practitioners are not required to check the database before prescribing controlled dangerous substances, and some don’t bother to do so. The only exception is methadone.

Although pharmacists are required to log controlled substance prescriptions into the system, current law does not require them to review a patient’s prescribing history before filling the order. Bureau officials said checking a patient’s history requires a different computer log-in process than entering prescription data.

If they do review a patient’s history and see evidence of multiple concurrent prescriptions, pharmacists have the authority to refuse to fill a prescription, alert the prescribing physician or contact state authorities, bureau officials said.

Drug enforcers say it is difficult to compare Oklahoma’s PMP data with prescribing rates in other states because few states collect as much data as Oklahoma does. Oklahoma, for example, includes the painkiller tramadol in its PMP tracking system; other states don’t. Some states track only a short list of potent controlled substances, such as opioid painkillers.

The PMP data does not cover all narcotics administered in the state. Hospitals are exempt, as are some Indian Health Service and Defense Department facilities. Prescriptions dispensed at Veterans Administration facilities have been reported to the PMP system for only a few months.

Oklahoma’s doctors have resisted proposals to require them to use the system each time they write a prescription for a controlled substance.

Two years ago, the Oklahoma State Medical Association sent a letter to lawmakers saying mandatory PMP checks for every narcotics prescription “will require additional staff time and resources in physicians’ offices and result in higher costs and longer waits for patients.” It urged them to reject the proposal.

But the medical group says it is willing to consider a less comprehensive mandate, one that requires occasional checks and lets office staffers handle the job instead of the requiring doctors to do it.  

“We are meeting with the governor’s staff and all of the stakeholders involved with that,” said Ken King, executive director of the medical association. “We want to make sure that any solution is a true solution, and not something that tries to make the physician the policeman in this process.”

State Medical Association President Robert McCaffree, a pulmonary disease physician, said Oklahoma doctors continue to hear a mixed message about the use of prescription painkillers.

“We’re often told as physicians that pain is undertreated,” McCaffree said.

“But we also have this issue that there are prescription drug abuses. The physicians are caught in the middle. How do we best be the advocates for our patients but also be responsible to society?”  

State officials said they will look at several options for new legislation to increase physician use of the PMP. At one extreme, physicians could be required to check the database every time they write a new prescription for frequently abused controlled substances.

But a more incremental approach appears likely, Mullins and others said. Physicians might be required to check the database every six months, or once a year, for frequent patients, or before writing a prescription for new patients.

Vorse said his staff checks the PMP every time he writes a prescription for a controlled dangerous substance, even with patients he has been treating for years.

At a reporter’s request, he demonstrated what is involved in a PMP check. It took him about 90 seconds to log onto the system with a laptop computer and review the reporter’s prescription history.

“Just last week I picked up a relapse in one of my patients who had started getting narcotics from another doctor,” he said. “If I hadn’t done a PMP, I never would have picked it up.”

Oklahoma Watch is a nonprofit, nonpartisan journalism service that produces in-depth and investigative content on important public-policy issues facing the state. For other content, go to www.oklahomawatch.org.

Text Only
National and world
  • Illinois Unemployment_Hass.jpg As U.S. job market strengthens, many don't feel it

    "If the economy is getting better, I'm not sure for whom. It certainly hasn't trickled down to me." — Douglas Hunter, who earned $14 an hour before the Great Recession and now works three days a week for $9.25 an hour, mopping floors and fixing fryers at McDonald's.

    July 31, 2014 1 Photo

  • House Obama Lawsuit.jpg Republican-led House approves lawsuit against President Obama

    Just a day before lawmakers were to begin a five-week summer recess, debate over the proposed lawsuit underscored the harshly partisan tone that has dominated the current Congress almost from its start in January 2013.

    July 31, 2014 1 Photo

  • Russia Putin web.jpg Sanctions could damage Russia

    The sanctions go further than earlier penalties — which had largely targeted individuals — by broadly limiting the trade of weapons and of technology that can be used in the oil and military industries. The EU also put its capital markets off-limits to Russian state-owned banks.

    July 31, 2014 1 Photo

  • Mideast Libya web.jpg Thousands flee to Tunisia to escape Libya fighting

    Many diplomats, including the U.S. ambassador, have pulled out of the country. With the interim government paralyzed, the fighting threatens the planned opening session of the newly elected parliament on Aug. 4.

    July 30, 2014 1 Photo

  • Obit Robert Drew web.jpg Cinema verite documentarian Robert Drew dies

    Starting in 1960 with “Primary,” Drew produced and sometimes directed a series of television documentaries that took advantage of such innovations as light hand-held cameras that recorded sound and pictures.

    July 30, 2014 1 Photo

  • Obama Ukraine Russia_Hass_W.jpg GOP-led House approves lawsuit against Obama

    The suit will contend that Obama has exceeded his constitutional powers in the way he has enforced the 2010 health care law.

    July 30, 2014 1 Photo

  • Texas: Gay-marriage ban best for children

    Texas’ ban on same-sex marriage allows the state to promote the birth and upbringing of children in “stable, lasting relationships,” the state’s attorney general argued Tuesday while asking a federal appeals court to reinstate the ban.

    July 30, 2014 1 Story

  • OKCupid, Facebook not alone in studying consumers

    Dating is hard.

    July 29, 2014

  • Abortion-Mississippi_Hass.jpg U.S. appeals court blocks Mississippi abortion law

    The 5th U.S. Circuit Court of Appeals voted 2-1 to overturn Mississippi’s 2012 law requiring abortion doctors to obtain admitting privileges at nearby hospitals.

    July 29, 2014 1 Photo

  • U.S. Court: Virginia marriage is for all lovers

    “We recognize that same-sex marriage makes some people deeply uncomfortable. However, inertia and apprehension are not legitimate bases for denying same-sex couples due process and equal protection of the laws,” Judge Henry F. Floyd wrote.

    July 28, 2014

Featured Ads