I’ve never heard of this group, but this is a pretty complete and accurate report. And it gives pain patients a more overall look at why they’re being treated like criminals.
Prescription Drug Fraud and Misuse (2012)
Guide No. 24
2nd Edition (2012)
Prescription Drug-Related Problems
Medicaid fraud. Pharmacy workers sometimes commit Medicaid fraud, usually by substituting generic drugs for name brands, short counting pills, filling prescriptions without a refill, and then overbilling Medicaid. They may also bill Medicaid for drugs they never dispensed.1
Over-the-counter (OTC) drug misuse. Those who purchase OTC drugs to achieve a “high” are typically youth seeking cough and cold medicines, sleep aids, antihistamines, and anti-nausea agents.2 It is not known to what extent the misuse of OTC drugs increases the risk for prescription drug misuse and/or fraud, or illegal controlled substance use (e.g., heroin use).
This seems like it would be important to know, so one has to wonder why these studies haven’t been done. Big Pharma has the power to keep these studies from being done right now, but eventually, parents will want to know if these easily-accessed OTC drugs are one of the reasons their children became addicted to prescription medications. (Although this would be another version of the gateway theory, that has been debunked time and time again.)
Theft from pharmacies, hospitals, and doctors’ offices. Pharmacy workers and healthcare providers, both of whom have easy access to prescription drugs, sometimes steal them…
The medical industry is very good at protecting their own, just like law enforcement. There is little media coverage of incidents like this. And while that’s how it should be, it leaves pain patients taking the blame for a lot of activity that they’re basically unaware of.
Other Drug-Related Problems
Some of the following problems related to prescription fraud and misuse are covered in other guides in this series, all of which are listed at the end of this guide:
Open-air drug markets
Drug dealing in apartment complexes
Marijuana growing operations
Clandestine methamphetamine labs
Mobile drug dealing
The National Survey on Drug Use and Health reports that fewer than 1 percent of those engaged in nonmedical prescription drug use in 2009 obtained those drugs through the Internet. One researcher concluded, “The assertion that the Internet has become a dangerous new avenue for the diversion of scheduled prescription opioid analgesics appears to be based on no empirical evidence and is largely incorrect.”
Purdue Pharma’s 10-Point Plan to Reduce Prescription Drug Abuse and Diversion
Educate healthcare professionals about the problem.
Create tamper-resistant prescription pads.
Implement programs such as Painfully Obvious, a prescription drug abuse awareness and education initiative for middle and high school students.
Provide opioid therapy documentation kits to physicians for pain assessment.
Distribute educational brochures about the problem.
Implement prescription monitoring programs.
Establish educational programs with the law enforcement community.
Conduct research on abuse, diversion, and addiction.
Work with the DEA to curtain cross-border smuggling.
Develop abuse-resistant drugs.
Jurisdictions such as Albuquerque, New Mexico; San Diego, California; and Tarrant County, Texas, use FaxAlert to notify doctors, pharmacies, and medical clinics of drug diversion-related activity. Each month, the Tarrant County Medical Society also distributes a health-scam report. The Texas Pharmacy Association has set up an online system for reporting fraud or stolen prescription pads. The state of Colorado and Johnson County, Kansas, use a PharmAlert hotline for notification, while Abington, Pennsylvania, police handed out fliers describing the scam and including a photo of the suspect or fraudulent prescription. After implementing this strategy in 1991, Abington saw arrests of prescription fraud offenders increase from one per year to one to two per month…
An extensive study of Maine’s PMP found that prescribers have used PMP data to confirm doctor shopping, and make referrals for substance abuse. It also found that “a chilling effect has not occurred.”76 Michigan found that its electronic system reduced handling time and did not increase cost,77 and a satisfaction survey conducted in Kentucky revealed that “nearly 90 percent of prescribers have used a Kentucky All Schedule Prescription Electronic Reporting (KASPER) report to help with the decision to deny medication to patients” and 94 percent of police strongly or somewhat agree that KASPER is an effective tool for obtaining evidence in the investigative process…
These take-back programs may be seen as similar to the popular, but ineffective, “gun buy-back” programs of the 1990s. While there are similarities in that people are voluntarily turning in something that may be illegal, with no questions asked, they are different in that no money, vouchers, or goods are being given in exchange. Other possible similarities include that people dispose of their old, uninteresting drugs much in the same way that the majority of firearms turned in are antique and inoperable. Anecdotal evidence from the Reno Police Department suggests that drug take-back programs increased awareness of the dangers of prescription drugs and their potential misuse, but the medicines collected were not high on the list of misused or fraudulently obtained prescription drugs…
Because of the high number of prescription fraud offenders who are professionals (many in the healthcare field), police investigators believe this is an important factor in an effective response. Similar to the Drug Court concept is Nevada’s Pre-Criminal Intervention Program where an intervention officer from the Board of Pharmacy works with prescription drug users who have a high potential for misuse and fraud. Candidates are identified through PMP data and doctor-shopping criteria. A study of the program showed a large reduction in the average number of prescribers, dispensers, and prescriptions filled.83
Some progress in linking PMPs has been made through a pilot project called PMIX…
Enforcement crackdowns usually yield an immediate but limited impact and often do not produce long-term results. A police or medical-board crackdown on a specific doctor, pain clinic, or pharmacy prone to prescription fraud and misuse may put that doctor, pain clinic, or pharmacy out of commission, but prescription drug misusers will simply move on to the next doctor or pharmacy that does not have sufficient prevention measures in place. Given the inadequate amount of resources devoted to crackdowns on prescription fraud, the practice cannot be sustained as a means to prevent or reduce the problem.
Everyone knows that enforcement crackdowns do more harm than good, leaving thousands and thousands of pain patients without any access to health care or prescription medications — although this report doesn’t even mention that group. (We have been forgotten.) This is the story that’s not being sufficiently covered in the media — the stories of chronic pain patients. Really, all this report is doing is supporting the need for a PDMP system that is used the same way by every prescriber in every state. I don’t know what else to call this except a blacklist.
I have heard that CVS has a “black list” of doctors that they are refusing to fill.
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.
From a pain patient’s perspective, what I see in this report is an elaborate collection of information that actually proves that the PDMPs and all these law enforcement efforts are only making the problems worse. (See the nationwide increase in drug abuse and poisonings.) I understand that for a digital system like this to work, just about everyone has to use it. And that includes all levels of law enforcement and other government agencies. Next, more insurance companies like Express Scripts will want in on the action too, but they probably already have access anyway.
This is the Drug War, people.