Prescription Drug Monitoring Programs (PDMPs) are highly effective tools utilized by government officials (usually states) for reducing prescription drug abuse and diversion. PDMPs collect, monitor, and analyze electronically transmitted prescribing and dispensing data submitted by pharmacies and dispensing practitioners. The data are used to support states’ efforts in education, research, enforcement and abuse prevention.
States recognize the medical need for controlled substances and, therefore, PDMPs do not interfere with appropriate, medical use. Prescription data is provided only to entities authorized by state law to access the program, such as health care practitioners, pharmacists, regulatory boards and law enforcement agencies.
PDMPs are proactive in safeguarding public health and safety while supporting the legitimate use of controlled substances. PDMPs do not infringe on the legitimate prescribing of a controlled substance by a practitioner acting in good faith and in the course of a professional practice. Each state has a form of PDMP as an important step to improving opioid prescribing practices and reducing the availability of those drugs in an effort to reduce misuse, abuse and overdose deaths.
I still remember vividly the day my youngest son said to me, “Mom there are people your age all over the county who are making a living off of someone like me with anxiety and depression.” This came after he had suffered for five years following the death of his eldest brother to an accidental overdose. I honestly had never heard of such a thing. Perhaps I was blissfully ignorant of the possibility that people actually did that. Seriously, where did I think street drugs came from? Of course, the story is that the journey to addiction for both of my boys came directly from the hands of people who sold their prescription pain medication for profit.
My eldest son had self-admittedly become addicted to Oxycontin while finishing up college. He had already completed a detox and treatment program to abstain from that use prior to even telling me. It was through a river of tears that he cried, “Mom I’m addicted to pain pills. You know that its heroin in a pill Mom, heroin in a pill!” he exclaimed. Oh my God, no, this cannot be true. How did I not know this? More importantly, how did I not ask the question about how he got the pills to begin with? He was in college, working two jobs, creating music and writing as always; he was not ill, suffered no injury and to my knowledge was not in any pain. What a fool I was. Even as I write this, I cannot understand why I never asked where those medications came from.
What I will always remember is the profound way he described the scenario with honesty, shame and sadness. It was devastating for us both. He stated that he wanted to go through the treatment program successfully on his own before telling me. He described how money that I had given him toward rent had been used at a treatment center each week where he would pee in a bottle and then receive Suboxone to assist him with getting off the drugs he had become dependent on. He said, though he felt good to have come out on the other side of that addiction, he was terrified because “alcohol was calling his name.” He had been counseled to be wary of alcoholism. Years later my son would confide in me, after he had in fact become an alcoholic, that he thought “it was the nastiest, dirtiest, and ugliest addiction of all because alcohol use was widely expected and accepted.”
Clearly, my eldest son had demons and, forever now, unexplained pain in his heart that rendered him helpless to self-loathing messages that could not be silenced. My youngest son, who had Asperger’s, never recovered after losing his brother. His use was directly related to wanting to just feel normal and not sad. To find a way to fill that hole in his heart that rendered him broken.
PDMP’s will not remove all street drugs. The potential is there to eliminate proliferation of prescription pain medicine from the streets with an expectation to curtail private sales of one’s own medications and the “shopping” for providers and emergency rooms for more prescriptions by sellers. Prescription database requirements will save precious lives. The ability of individuals to obtain multiple opioid prescriptions from multiple providers is just one focus for the implementation of PDMP’s. It has a very personal effect for me as described in the my op-ed article written on behalf of Shatterproof, that appeared in the Napa Valley Register and Sonoma County’s Press Democrat, June 12, 2016, ahead of the CURES ACT becoming law in California and PDMP which went into effect in October 2018.
The opioid epidemic facing our state is one of the worst healthcare crises California has ever seen. In 2014, California had the largest number of overdose deaths of any state in the country: 4,521 of our sons, daughters, and loved ones lost.
Diana Lynn is a resident of Northern California and an Ambassador for Shatterproof.org, a national non-profit organization focused on ending addiction. Napa Valley Register & Press Democrat (June 16, 2016)
While the statistics are staggering, they are much more than just numbers to me. I have lost half of my family, two of my four beloved children, to this disease. First, when my eldest son died at the age of 27 in 2008. My youngest son, who once said “Mom, people your age are making a living off of someone like me with depression and anxiety,” sadly also died at the age of 22 in 2014. The boys’ use of prescription pain medications for depression and anxiety reached a tragic end with addiction to opioids and ultimate overdose. After several months in residential treatment, each in active recovery, they tragically passed when attempts to keep the shame and stigma of addiction at bay were unsuccessful.
My precious sons did not want to be dependent on any substance and they certainly did not want to die before they had a chance to truly live. Thousands of families in California and across the country, like mine, are being shattered by this epidemic. Thousands more will face the same pain if we don’t change the system now.
Today, California has the opportunity to reverse this epidemic. Among the most effective options is using technology to track a patient’s prescription history (also known as Prescription Drug Monitoring Programs or PDMPs). Earlier this year, California rolled out its new PDMP.
By fully utilizing technology that the state has already invested in, providers can review a patient’s history to ensure they are not prescribing a drug that could be lethal in combination with another medication the patient is currently taking. They can also make sure someone isn’t “doctor shopping” and receiving an unsafe number of prescriptions from multiple providers.
In California, prescribers are not required to use the technology, rendering it almost useless – like offering a seatbelt in a car but not mandating drivers and passengers use it.
To solve this, California State Senator Ricardo Lara (D-Los Angeles) introduced SB482 last year. SB482 would require physicians to check the state’s PDMP prior to prescribing an opioid and annually thereafter to monitor for harmful drug combinations.
Similar requirements enacted in New York, Tennessee and Kentucky led to dramatic improvements in prescribing patterns in those states. In recent months Connecticut, Wisconsin Massachusetts, Ohio and Maryland passed requirements for doctors to check their state database before prescribing opioids. This solution works.
Since losing my sons, I realized I could not watch idly as other families were destroyed by this epidemic. I became an Ambassador for Shatterproof, a national nonprofit organization focused on ending addiction. After this bill passes, we will have hit a tremendous milestone that will serve as the entry point for making opioid abuse a thing of the past.
Providers need to have access to a patient’s comprehensive prescription history so they can safely prescribe opioids and other medications. Shatterproof will continue to be the voice of parents and families who have been touched by addiction as long as there is work left to be done.
I urge the Business and Professions Committee and the Assembly to pass the strongest and most effective bill possible. California has a state-of-the-art PDMP and has the opportunity to once again set the standard for the country for effective use of the system. Please take every measure available to save lives and protect families.
*For more information, on California’s CURES PDMP go to https://oag.ca.gov/sites/all/files/agweb/pdfs/pdmp/cures-mandatory-use.pdf
*To check your state’s PDMP go to the Center of Disease Control at:
https://www.cdc.gov/drugoverdose/states/index.html
*Click below to download the CDC PDMP two page factsheet.