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Controlled Substances Databses

Posted Aug 12 2010 11:24am
The Boston.com web site posted a Boston Globe article by Stephen Smith dated August 12, 2010 entitled " State OK’s tool to detect prescription drug abuse ."

Full of informative facts, the artilce states that "State health regulators yesterday unanimously approved the new detection system designed to stop “doctor shopping’’ by addicted patients who try to dupe doctors into prescribing narcotics. The practice, specialists said, has fueled a surge in drug-related deaths in Massachusetts, where abuse of painkillers poses a health threat that rivals heroin and other street drugs."

It describes a Kentucky system that is similar in nature and raises the issue of security breaches.
Concerning Massachusetts:: "The state is spending about $1 million to strengthen prescription monitoring and will commit $400,000 annually to maintain the initiative. Health authorities said they expect the state’s health insurance program for the poor will save $2 million a year by spotting abusers.

Managing prescription drug information has been a challenge. Massachusetts' early experience was described by Gottlieb et. al. in a 2005 article entitled: " PERSPECTIVE: Regulatory And Policy Barriers To Effective Clinical Data Exchange: Lessons Learned From MedsInfo-ED ."

My states, including my own, have implemented databases of controlled substances, but one wonders.....

If every practitioner is going to have access to e-prescribing software and this software enables review of a comprehensive medication history, then why would any clinician have to resort to a separate database to determine a patter of prescription drug use? Will this not, automatically, realize the alleged benefits of spotting prescription drug users?

If this is the case, then the only rationale for a dedicated database is either that this database is more comprehensive or that the database allows for queries across populations. The former would be difficult to support. The latter in my own mind is the only rational purpose for a dedicated database, and even then, one suspects a contract with the same organizations who prescribe data for individual care could be created a lesser expenditure.

I wrote about such an idea a year ago .

Am I missing something?
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