The growing awareness about the abuse of prescription painkillers hasn't kept the problem from skyrocketing. In 2008, 14,800 people died of an overdose, according to the Centers for Disease Control and Prevention, more than overdose deaths from cocaine and heroin combined.
Prescription drug monitoring programs that allow doctors to track who's prescribing and dispensing powerful painkillers, such as OxyContin and Vicodin, can help curb patients' so-called doctor shopping. That's when people go to lots of doctors to load up on painkiller prescriptions.
But the databases for checking up on patients only work if health care providers use them, and often that's not happening. Some insurers are taking matters into their own hands, including a big one in Massachusetts that will soon make doctors justify prescriptions for pain pills that exceed a 30-day supply.
More than 40 states have systems in place to monitor prescription drugs, according to the National Alliance for Model State Drug Laws. Typically, dispensing data from pharmacies is uploaded into a centralized database that physicians and other health care providers can query.
But the programs are voluntary, and many clinicians remain unaware of them, according to a recent article published in the New England Journal of Medicine.
There are other difficulties. The data may only be updated once a month. And the systems are often cumbersome to use, a sticking point for busy clinicians.
Utah anesthesiologist Perry Fine, a past president of the , says that it's in patients' best interest that their doctors know which drugs they're taking to ensure proper treatment.
The database in Utah is pretty easy to use, he says. But in many states, that's not the case. "Because they're not very functional or accessible or complete, overall utilization hasn't been very great," he says. As the state systems evolve, that may change, but for now, "They're not mainstream."
And the drug-monitoring systems in some states, such as California, have suffered from cuts in funding.
Still, there's traction in other states. New York Gov. Andrew Cuomo is expected to sign legislation that would require doctors in the state to prescribe drugs using computers rather than paper, the Associated Press reported. Pharmacists would be required to promptly enter information about painkiller prescriptions into a statewide database, too.
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