Prescription Drug Monitoring Program

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As of Jan-11-2012, 48 states had enacted legislation to create a Prescription Drug Monitoring Program (PDMP) and 40 states had an operational PDMP (1). The prevention of controlled substance abuse in the United States is a national public health priority (2). PDMPs allow a state to record and distribute information regarding a patients controlled substance medication history to help patients better manage their care (8).


Goals and Objectives of PDMPs

Most PDMPs have a similar objective but each state defines the goals differently. Listed below are the main goals that the National Alliance for Model State Drug Laws (NAMSDL) believes are the main objectives (5):

  • 1. Support access to legitimate use of controlled substances
  • 2. To identify, deter, or prevent drug abuse and aversion
  • 3. Identification, facilitate intervention and treatment for those addicted to prescription drugs.
  • 4. Inform public health initiatives through use and abuse trends
  • 5. Educate individuals about PDMPs and the issues surrounding controlled substances (5).


How PDMPs work

There are a number of ways the a PDMP can be administered but nearly all monitor prescriber habits and dispensing records from pharmacies of scheduled narcotics ranging from CII-CV depending on the state (3). The data is then aggregated and distributed to organizations and individuals as authorized by the PDMP law.


Information Recorded by PDMPs

The database will contain records for every patient that receives a controlled prescription that is being monitored in that state (--regardless of method of payment. Oregon's PDMP requires pharmacies to submit the following information (7):

  • Pharmacy DEA
  • Patient Demographics (First and Last Name, Address, DOB)
  • Prescription information (date written, date filled, Product [NDC Number], Product ID, and Quantity dispensed)
  • Prescriber Information (DEA Number, First and Last Name) (7).


Users and Entities Authorized to Access the PDMP

Individuals and entities authorized to access the PDMP database generally include (5):

  • Licensed physician's/ practitioner's with prescribing authority
  • Licensed pharmacists
  • Law enforcement agencies
  • Certification or regulatory boards, commissions, agencies and their respective representatives.
  • Individuals with a record in the PDMP (on a request basis only).

PMPs allow providers to look up a patient's controlled substance history before writing a prescription for such drugs (5). This will allow providers to identify those patients that are "doctor-shopping" or using multiple pharmacies in order to abuse controlled prescriptions. In 18 states, practitioners are not required to use the PDMP when writing or dispensing a controlled medication (5). However, 7 states require practitioners to access the PDMP under certain circumstances (5).


Confidentiality and Privacy of the PDMP and Patient Information

Most states have explicit language written into the law requiring the organization administering the PDMP to comply with all relevant federal and state privacy laws. Additionally, some states require the organization to develop it's own procedures for ensuring confidentiality. Seventeen (17) states require that data be purged from the database after a mandated number of years (5).

The Health Insurance Portability and Accountability Act (HIPAA) allows a state authorized PDMP to authorize a patient's prescription history without explicit patient consent (4). Oregon, for example, allows every patient with data in the PDMP to obtain a free copy of their PDMP record and view an access audit to know who has accessed their record (6).


External Websites

Here are additional resources that have more information. Many include links to individual state PDMP websites.

  • Alliance of States with Prescription Monitoring Programs: [1]
  • DOJ/DEA Office of Diversion Control FAQ: [2]
  • National Alliance for Model State Drug Laws: [3]
  • Pain & Policy Studies Group (Prescription Drug Monitoring Page): [4]
  • Florida Prescription Drug Monitoring Program: [5]
  • Oregon Prescription Drug Monitoring Program: [6]


Citations

****All citations accessed 3-12-2012****

  • 1. National Alliance for Model State Drug Laws (NAMSDL): [7]
  • 2.Joranson, D; et. al.: [8]
  • 3. Pain & Policy Studies Group: [9]
  • 4. Florida Office of Drug Control: [10]
  • 5. NAMSDL: [11]
  • 6. Patient Rights, Oregon Prescription Drug Monitoring Program: [12]
  • 7. Uploader's Implementation Guide. RxSentry. Oregon Health Authority: [13]
  • 8. Oregon Prescription Drug Monitoring Program: [14]


Submitted by Matthew Pharr