(2009) The Influence of Prescription Monitoring Programs on Chronic Pain Management

Click to access 2009;12;507-515.pdf

Background: Abuse of prescribed controlled substance has become a serious social as well as health care issue over the past decade. A particularly alarming trend exists among patients aged 12 to 17. [This is from 2009, but the current problem is not in this age group.] Common abuse behaviors include doctor shopping, drug theft, feigned pain symptoms to gain health care access, drug sharing, prescription forgery, and improper prescription practices. In response to this epidemic of abuse, many states have adopted prescription monitoring programs (PMPs). Such programs first originated in the early twentieth century. As of 2006, 38 states had such programs, many of which are supported by federal grants. As PMPs become more widespread, they have also increased in sophistication. By keeping a record of the prescription and dispensing of narcotics, these programs are able to build a comprehensive data network for tracking [certain] prescription medications. These databases aid law enforcement agencies in investigations of narcotic trafficking; they also help state regulatory boards to monitor improper prescription practices.

Is there any purpose listed here that would help patients or doctors?  No, this is strictly for law enforcement.

And if these programs have been around since 2006 — and we’re in the middle of this opioid “epidemic” — it doesn’t look like they’re providing much help, does it?

Of course, since illegal heroin isn’t tracked by the PDMPs, the current heroin “epidemic” isn’t getting much help from these federally-funded programs either.  But if you think about it, what kind of help would the PDMPs offer the DEA for reducing the supply of illegal heroin?  Why, since it is often quoted that opioid medications are the gateway to heroin abuse in a “majority” of cases (I’ve seen quotes as high as 90%), then finding the patients who “abuse” opioids will be like the “broken windows” policy of catching potential criminals before they become actual criminals.

Conclusion: Many states have developed PMPs to help regulatory agencies as well as physicians detect prescription drug abuse. Limited data so far suggest that such programs reduce abuse practices. In addition, proactive usage of the data further prevents abuse.

Since drug abuse is a crime, “detecting” it means involving law enforcement.  And if you’re a pain patient, and your history includes a mistake and/or the involvement of any kind of law enforcement, then you will no longer find access to treatment through the health care system. You will be blacklisted.

And it is my contention that the PDMPs are a blacklist for pain patients.

Wikipedia’s page for Blacklist (computing):  In computing, a blacklist or block list is a basic access control mechanism that allows through all elements (email addresses, users, URLs, etc.), except those explicitly mentioned. Those items on the list are denied access.

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