Patient advocates say the opioid abuse bill Congress passed this month—even without the additional funding many wanted—will open doors for people seeking treatment by effectively decriminalizing addiction.
But some of the same people say lawmakers blew an opportunity to strengthen the country's ability to track the opioid prescriptions that are fueling an epidemic of overdose deaths. An older version of the Comprehensive Addiction and Recovery Act would have boosted grants for databases that flag overusers of prescription drugs—but only for states that require physicians to check those databases before writing a prescription. But physicians lobbied against the requirement, arguing that it was burdensome and that the databases, known as prescription drug monitoring programs, often failed to provide the most updated and comprehensive information.
The final bill provides the grant money but eliminated the requirement. Gary Mendell, founder and CEO of the national anti-addiction advocacy organization Shatterproof, said the omission could have a potentially “tragic effect for families across our country.”
“Without this incentive tied to federal grants, legislation at the state level will be adopted slower than it would with grants conditioned upon this requirement,” he said.
Prescription drug monitoring programs, or PDMPs, were first established by states in the 1930s. The programs now exist in every state and the District of Columbia with the exception of Missouri, where repeated attempts in the Legislature have faced opposition from privacy rights groups.
The databases collect, monitor and analyze information from pharmacies and prescribers to identify whether a patient is seeking multiple prescriptions of a medication such as an opioid, a practice most commonly known as “doctor shopping.”
The programs also alert providers when a patient has been prescribed other medications that could be dangerous when mixed with an opioid. For example, studies show mixing opioids with tranquilizers increases the likelihood of an overdose by four times.
Evidence suggests that providers who use the databases prescribe fewer opioids. A Health Affairs study in June found a 30% reduction in the rate of Schedule II opioid prescribing from 2001 to 2010 among 24 states immediately after launching a drug monitoring program.