Wolf proposal would have doctors check pill database
July 6, 2016 11:33 PM
Gov. Tom Wolf, shown in May at an opioid roundtable at Carnegie Library of Pittsburgh Homewood, wants to require that all of the state’s physicians check patients’ drug histories in a database every time they prescribe controlled substances.
Matt Rourke/Associated Press
Gov. Tom Wolf wants a law that requires all state doctors to check patients' drug histories in a new database medical history when they prescribe controlled substances, including opioids.
By Rich Lord / Pittsburgh Post-Gazette
In an effort to plug one of the biggest holes in Pennsylvania’s anti-drug effort, Gov. Tom Wolf wants to require that all of the state’s physicians check patients’ drug histories in a new database every time they prescribe controlled substances, including opioids, a spokesman said Wednesday.
The proposal comes as data from coroners and medical examiners indicates that Pennsylvania saw 3,383 drug overdose deaths last year, a 23.4 percent jump from the prior year’s tally. Nearly 81 percent of the overdose victims tested positive for one or more opioids, mostly heroin, fentanyl and oxycodone.
Proposed amendments to legislation that has passed the Senate, and awaits action with the House, would demand that every prescriber check the coming prescriptions database “each time a patient is prescribed a controlled substance,” to see if their patients were getting medications from multiple doctors, according to language provided to the Pittsburgh Post-Gazette.
“We need medical professionals to know, when they’re prescribing drugs to individuals, what the [patient’s] history is,” said Jeff Sheridan, the governor’s spokesman. “It would require prescribers to check the database. They would make their own clinical judgment on whether or not to prescribe a controlled substance.”
Some of the legislators who have been trying to curb opioid prescribing promptly endorsed the governor’s concept, and representatives of the medical industry were noncommittal.
The Post-Gazette in May identified the state’s lack of an effective prescription drug monitoring program as one of the most serious gaps in its response to the opioid and heroin crisis. The newspaper found that states with strong prescribing databases, and which vigorously disciplined physicians for lax narcotics practices, reduced the prevalence of opioids and slowed the increase in overdoses.
In 2014, the Legislature passed, and Gov. Tom Corbett signed, legislation to create a prescription database that doctors could use to learn a patient’s drug history. Forty-eight other states have such databases, and some use them to discipline loose-prescribing physicians.
Hamstrung for more than a year by a lack of funding, Pennsylvania’s so-called Achieving Better Care by Monitoring All Prescriptions, or ABC-MAP, database should be operational by August, Mr. Wolf has said. But the law governing it includes a gaping loophole.
The law demands that doctors check the database the first time they prescribe narcotics for a given patient — but not thereafter.
Mr. Wolf would like to add the proposed new requirement to legislation that currently demands that prescribers get two hours of continuing medical education in pain management and two hours in opioid prescribing practices every two years. That bill, sponsored by Sen. Gene Yaw, R-Lycoming, and Sen. John Wozniak, D-Johnstown, sailed through the Senate on a unanimous vote last month.
Mr. Yaw said that the language proposed by Mr. Wolf is “a work in progress,” adding that mandatory checking of the database “is necessary. I think that’s what we have to do.”
“I don’t think it’s unreasonable. I think it makes all the sense in the world,” said Rep. Gene DiGirolamo, R-Bensalem, another backer of tighter regulation of opioid prescribing. “These opioids have created such a crisis, an epidemic.”
The Pennsylvania Medical Society, which represents most of the state’s doctors, had no immediate reaction. In its recent “call to action” on opioids, the society wrote that doctors should “regularly use the Pennsylvania prescription drug monitoring system when considering whether to prescribe a controlled substance for a patient.”
The Hospital & Healthsystem Association of Pennsylvania has no position at this time, a spokeswoman wrote.
“With a background in pharmaceutical sales, I’m well aware of how difficult it is to be a physician but also how very important it is to know and fully understand the products that are prescribed and the risks and benefits,” wrote state Rep. Rosemary Brown, R-East Stroudsburg, in an email response to questions. “Often these excessive prescriptions lead to addiction as well as excessive pills being available to sell on the streets or leave in medicine cabinets.”
Ms. Brown’s separate House bill would also demand that physicians check the database when prescribing opioids, except in emergency room and inpatient hospital situations. It would also bar emergency room practitioners from prescribing more than a week’s worth of opioids, unless they document that there was no alternative. It passed out of that chamber on a 174-19 vote in late June, and now awaits Senate action.
On Tuesday, the Obama administration announced that the Indian Health Service and Veterans Affairs doctors must now check prescription databases, and the Department of Defense is reviewing its drug monitoring programs. The Department of Health and Human Services, meanwhile, is removing any remaining links between patient reports on pain management and hospital reimbursements, the administration announced.
Rich Lord: firstname.lastname@example.org or 412-263-1542. Twitter @richelord
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