Md. should mandate use of prescription drug monitoring programs

Md. should mandate use of prescription drug monitoring programs

By: Gary Mendell, The Baltimore Sun

The country’s opioid epidemic has reached a boiling point. Americans are dying every day from overdoses, and millions are struggling with addiction. The president has asked for $1.1 billion to combat the crisis — and it was a major issue for his would-be successors in New Hampshire, one of the states that’s been hit hardest.

But heroin and painkiller addiction doesn’t discriminate; it’s also a crisis right here in Maryland. The state’s health department says the number of overdose-related deaths has almost doubled since 2010. That’s two times as many of our loved ones lost. Opioid addiction frequently leads to heroin addiction, and heroin-related emergency room visits have tripled in five years. The numbers just keep rising.

Gov. Larry Hogan, Sen. Katherine Klausmeier and Del. Erek Barron have made fighting addiction a priority this session in the state legislature. Together, they have introduced a bill that requires the use of PDMPs — Prescription Drug Monitoring Programs. PDMPs hold patients’ prescription histories so doctors can check to identify potentially lethal combinations of prescriptions or high-risk behavior like doctor shopping. As simple as it may sound, this program has the ability to save lives — thousands of them. Maryland already has this database. But doctors don’t use it consistently, as many are unaware that it exists. Inconceivably, fewer than a quarter consult it before writing a prescription.

The data, when used properly, can warn health care providers when someone is at risk of addiction or overdose. Patients who “doctor shop” are seven times more likely to die of an opioid overdose than those who don’t. They are also more likely to be prescribed a potentially lethal combination of medications; patients who are taking opioids along with anti-anxiety pills like Valium and Xanax, quadruple their risk of an overdose.

In Maryland, over 300 patients who doctor shopped received a controlled substance from five or more prescribers during July 2015 alone. Nearly as many received prescriptions from 15 or more prescribers during the first nine months of 2015, with some seeing as many as 40 prescribers. This is unacceptable.

Twenty-three other states have required that physicians consult the database before prescribing opioids. Unsurprisingly, these mandatory use policies led to decreases in opioid prescriptions, doctor shopping and overdose deaths. This is not rocket science: it’s just common sense.

Maryland must join these states and enact legislation to mandate use of the state’s prescription drug database. It will not save everyone, but it’s a critical step toward preventing opioid-related deaths, with a minimal burden placed on health care providers. It defies logic that doctors are able to write prescriptions for highly addictive substances based only on a patient’s word.

Opioid addiction is a bipartisan issue. Legislators on both sides of the aisle should rally behind mandatory reporting; there should be no hesitation on the issue.

For me, this epidemic is personal. My wife and I lost our son, Brian, to opioid addiction in 2011. My wish is that no other parent suffer the same tragedy. This bill will save lives like his.

Gary Mendell is the Founder and CEO of Shatterproof, a national non-profit devoted to ending drug and alcohol addiction.

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