You go into your pharmacy and try to fill a prescription for a controlled substance, but the pharmacy staff tells you that it’s too soon to fill because you recently filled it at another pharmacy. How do they know when and what you filled if it was at another chain of pharmacies? Is “Big Brother” watching you?
The answer is no, “Big Brother” isn’t watching you, but healthcare providers and law enforcement officials may be. With the growing epidemic of prescription opioid drug abuse, states have implemented prescription drug monitoring programs (PMPs) to track suspicious behavior. PMPs are databases that collect and track electronic information submitted by pharmacies and prescribers regarding controlled substances. This data is then used to potentially reduce prescription drug abuse.
State laws authorize the creation of PMPs and regulate who is allowed access to their information. Right now, 49 states and Guam actively use PMPs. Most states allow healthcare providers and pharmacists to use the programs; some states may also allow law enforcement officials, boards of medicine or pharmacy, or medical examiners or coroners access.
How PMPs work
But how do these programs affect you? PMPs monitor information about the filling of controlled substances, which are drugs classified by federal and state laws as addictive and having the potential for abuse. When you fill a prescription for any controlled substance, like your pain medication or your anti-anxiety drug, that information is collected by your state PMP and added to your profile. Most states are now requiring prescribers to check the PMP before issuing a prescription and pharmacists to look at the database before filling it. If you’re only filling a controlled substance prescription because you just had surgery, you likely won’t have any issues. It’s when your healthcare provider or pharmacist see “suspicious” activity that you may run into problems.
When an authorized user looks up a patient’s profile and sees that the patient uses multiple pharmacies and doctors, it’s a red flag that the patient may be trying to fool the system. An even bigger alarm is if the patient uses his or her insurance to fill one prescription, but pays out of pocket for multiple prescriptions for the same drug during the same time period. PMPs collect data on all controlled substance prescriptions filled, not just ones processed through a patient’s insurance. While the patient may have a legitimate reason for this activity, to a healthcare provider or pharmacist it may seem like abusive behavior.
Most of the time you probably won’t even realize it if someone checks your PMP profile. But remember, if you are questioned about a prescription, that the purpose of these programs is to reduce prescription drug abuse and diversion, not to hassle patients filling legitimate prescriptions.