Pubdate: Wed, 31 Aug 2016
Source: Boston Globe (MA)
Copyright: 2016 Globe Newspaper Company
Contact: http://services.bostonglobe.com/news/opeds/letter.aspx?id=6340
Website: http://bostonglobe.com/
Details: http://www.mapinc.org/media/52

'DOCTOR SHOPPING' IS GOING TO GET MORE DIFFICULT

It may have taken a frightening surge in opioid abuse to speed 
action, but Massachusetts now has a user-friendly online system for 
keeping track of drug prescriptions. The state monitoring program 
went live last week, after a $6.2 million overhaul of an unwieldy 
system that many doctors avoided like a virus.

The new one is simple and fast. It pulls in real-time data from 
prescriptions written for controlled substances, including widely 
used opiates like oxycodone and hydrocodone. Doctors, nurse 
practitioners, and other prescribers have to consult the database 
before writing such a prescription for any new patient, as well as 
when they give existing patients their first prescription for a 
controlled substance.

Starting Oct. 15, they'll be required by law to log on before 
scribbling their signature on any narcotics prescription.

Right off, the system should discourage "doctor shopping" - that's 
when someone makes the rounds of physicians' offices and emergency 
rooms, feigning pain to collect a stash of pills.

The revamped database also might help doctors identify patients with 
chronic conditions who are unwittingly falling into a pattern of 
abuse or outright addiction.

Conversely, it should give doctors the confidence to prescribe an 
opiate for a patient who has no record of abuse and is in need of 
pain relief. "This can only improve the qualify of life and safety 
for patients," said James S. Gessner, president of the Massachusetts 
Medical Society. He's right - there's no obvious downside.

Still, the initial response to the monitoring system was sluggish - 
the medical mainstream doesn't easily change course.

By the end of last week, though, acceptance was spreading.

About 80 percent of Massachusetts' 46,634 prescribers had signed up, 
according to the Department of Public Health, and 71 percent of the 
25,457 doctors and other health professionals who prescribed an 
opioid during the last six months were on board.

More important, plenty of them are using the system.

The number of searches has topped 10,000 every day since the Aug. 22 
launch, said DPH spokesman Scott Zoback, and the average response 
time has been a zippy 1.5 seconds.

Of course, it's too soon to know how many of those inquiries changed 
a doctor's mind about how to treat a patient.

The database is just one tool in the effort to curb the scourge of 
opioids, and the technology is going up against a formidable force - 
human ingenuity.

Some people desperate to get their hands on a vial of Percocet won't 
limit their hunt to within Massachusetts borders. State officials say 
the monitoring system's data will be shared with similar programs in 
Connecticut, Rhode Island, and Vermont. New York is expected to be 
online by the end of this month, and there are plans for data sharing 
with Maine and New Hampshire. That's encouraging, but even greater 
coordination is needed to put a real squeeze on cross-border pill peddling.

Congress should act swiftly to establish and fund a national database 
modeled after Massachusetts' streamlined system.

This is one of those matters that really does involve life and death.
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MAP posted-by: Jay Bergstrom