What Can Happen When Doctors and Pharmacists Do Not Track Their Patient's Prescriptions copy

Opioid Abuse and the Prescription Monitoring Program

By —— Bio and Archives--October 17, 2017

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The Iowa Prescription Monitoring Program (PMP) is designed to provide patient specific prescription data to individuals authorized by Iowa Code (IC) section 124.553(1)(a) and 657 Iowa Administrative Code (IAC) Chapter 37. A prescriber or pharmacist is authorized to request a Patient Rx History Report on an individual only if: (a.) The request is for the purpose of providing medical treatment or pharmaceutical services; and, (b.) The prescriber or pharmacist has a current practitioner-patient relationship or is initiating a practitioner-patient relationship with the individual named in the request.

I read recently that only 42% of Iowa prescribers and 83% of pharmacists have voluntarily registered for the Prescription Monitoring Program. This is a system which allows those prescribing and dispensing opioids to access and track their patient’s prescription records and thereby detect and prevent the abuse of opioid medications. So far, registration with the PMP in Iowa is voluntary only, but forward thinking legislators such as Iowa Representative Shannon Lundgren of House District 57, have been pushing for legislation requiring physicians to register for the program, but not mandating its use, at least for now. In time perhaps prescribers will see the benefits of the program and enrol in greater numbers. Eventually use of the system may become mandatory. However, there is some resistance to that in the legislature presently.

Why should prescribers and pharmacists care? One case I defended,  illustrates how the lack of a PMP can contribute to abuse of opioids and (although this is not the concern of the physician but rather a side effect) illicit dealing of opioids—all of which has led to a national crisis of addiction.

“Jolene” was a 35-year-old blue collar worker from Iowa who was rear ended in a minor auto accident. She sued my client for alleged soft tissue injuries to her back and neck—a typical complaint in such cases. Her family doctor prescribed hydrocodone for her allegedly intractable back and neck pain. Her post accident records showed that her family doctor wrote multiple prescriptions for the drug. Although I am no medical expert, it did seem that she was taking a lot of the medication for such a minor accident. When I took her deposition, her sickly and sallow demeanor led me to believe that she had problems far greater than accident related back and neck pain. Suspecting that there was more to the story than meets the eye, and that she may have been less than candid about her pre-accident drug usage, I subpoenaed her records from every pharmacy in her hometown, and not just the one she disclosed to us in discovery. I was amazed at the results. Not only did “Jolene” obtain meds from her family doctor, but it turns out that she had seen four other doctors and gone to four other pharmacies—in each case alleging complaining of intractable back and neck pain. Careful not to tell each doctor about the others, and careful to get prescriptions filled at each of four separate pharmacies, she managed to acquire as many as 735 tabs of hydrocodone in a one month period of time. Clearly, she was not only abusing the medication, but she was dealing as well. After this was disclosed, the case settled quickly and for obvious reasons.

In fairness to the prescribers and pharmacists in this case, they were clearly the victim of a practiced liar who managed to ensure that no one knew about the others, and convince several doctors that she needed repeated prescriptions of this pain killer. Apparently, no one was suspicious or questioned her sincerity. But, had these folks access to the PMP program, this and other such cases may perhaps be discovered and abuse (and illicit dealing) prevented. I suspect hers is not an isolated case. It is a prime example of the need for the PMP program in Iowa and elsewhere. Although they cannot and would not use the PMP as a law enforcement tool, prescribers and pharmacists, using this system, can easily and confidentially track their own patient’s history of prescriptions and detect abuse and addiction which they might well otherwise never discover.

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William Kevin Stoos -- Bio and Archives | Comments

Copyright © 2017 William Kevin Stoos
William Kevin Stoos (aka Hugh Betcha) is a writer, book reviewer, and attorney, whose feature and cover articles have appeared in the Liguorian, Carmelite Digest, Catholic Digest, Catholic Medical Association Ethics Journal, Nature Conservancy Magazine, Liberty Magazine, Social Justice Review, Wall Street Journal Online and other secular and religious publications.  He is a regular contributing author for The Bread of Life Magazine in Canada. His review of Shadow World, by COL. Robert Chandler, propelled that book to best seller status. His book, The Woodcarver (]And Other Stories of Faith and Inspiration<strong>) © 2009, William Kevin Stoos (Strategic Publishing Company)—a collection of feature and cover stories on matters of faith—was released in July of 2009. It can be purchased though many internet booksellers including Amazon, Tower, Barnes and Noble and others. Royalties from his writings go to support the Carmelites. He resides in Wynstone, South Dakota.

“His newest book, <strong>The Wind and the Spirit (Stories of Faith and Inspiration)
” © 2011, is scheduled for release in the summer of 2011. All the author’s royalties go to support the Carmelite sisters.”

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