Doctor-shopping for opiates and other addictive drugs has become more challenging in New Jersey and the surrounding region, thanks to agreements that link the Garden State’s database to records in five other states, including Pennsylvania.
Gov. Chris Christie announced Wednesday that Massachusetts, New Hampshire, Maine, and West Virginia were recently connected to the New Jersey Prescription Monitoring Program, a centralized database launched in 2011 to help reduce prescription abuse.
Connecticut, Delaware, South Carolina, Rhode Island, Virginia, and Minnesota were already enrolled in the program, and New York was added last year. Christie said interstate use of the system skyrocketed more than 500 percent between 2015 and 2016 and interest spiked further during the first quarter of 2017.
The expansion was welcome news to state Sen. Joseph Vitale (D-Middlesex), who worked with other lawmakers to strengthen the database and who has been eager for both New York and Pennsylvania to join the program. “Joining together, especially with states that border New Jersey, will assist in reducing drugs that would be diverted for sale on the black market, and will be a useful tool for providers to identify those who may be misusing drugs and who need help,” he said.
Cuts down overdoses
Christie also said the PMP has been expanded to allow physicians to review two years’ worth of prescription records, instead of just one. In addition, the system now automatically converts all medicines to a standard “morphine milligram equivalent” dose, to help avoid over-prescribing or patient overdose. (Research has shown that many heroin users first became addicted to opiates or other prescription drugs.)
The governor has placed a growing priority on anti-addiction efforts, particularly in his last year in office, with a focus on reducing the flow of highly addictive prescriptions that can be misused or diverted for sale. In February he signed a law that strictly limited first-time opiate prescriptions for acute pain. And in April, President Donald Trump tapped Christie to lead the President’s Commission on Combatting Drug Addiction and the Opioid Crisis, through which the governor planned to rally other state leaders around evidence-based solutions.
“The NJPMP is perhaps the most immediate and direct way my administration is bringing America together to fight the deadliest health crisis of our time,” Christie said. “We will keep growing the NJPMP, as bipartisan leaders of more states recognize it is an invaluable solution to protect people from the disease of addiction and to connect tens of millions of people with immediate treatment, including those who otherwise would have been lost under the radar.”
Use of database mandatory for doctors, pharmacists
The prescription database, which now contains some 73 million entries, was not mandatory for all physicians at first. Vitale and his colleagues led efforts to strengthen the program and today physicians must look up a patient’s drug history the first time they plan to prescribe opioids and other addictive drugs, including human growth hormones. Doctors are also required to check the database at certain intervals if they are providing refills. They can designate another professional in their office to perform the searches.
Pharmacists also are required to check the system before dispensing drugs to anyone they suspect may be misusing or abusing a prescription. Pharmacy data is downloaded into the system once a day. In order to utilize the system all users must register with the state and must pledge to access the information only to benefit patients. Members of law enforcement can also be granted access in certain cases.
Such databases — the use of which is mandated for prescribers in nearly two dozen states — are designed to help physicians and pharmacists identify patients showing potential signs of abuse, like regular requests for higher doses, and curb doctor-shopping, in which an individual visits multiple providers to collect pills to sell. While some physicians raised concerns about the time and additional red tape involved with using the system, the profession appears to have largely embraced the program.
According to American Medical Association data, there were more than 136 million registered database inquiries nationwide in 2016 — some 50 million more physician searches than were done the previous year and more than twice the number conducted in 2014. In New Jersey, searches grew steadily from 1.4 million in 2014 to nearly 2.5 million last year.
Perhaps most importantly, the use of these databases appears to be having an effect, the AMA findings suggest. Between 2013 and 2016 opioid prescriptions dropped 14.6 percent nationwide; there were still more than 215 million scripts written last year. New Jersey’s use of these medicines declined 11 percent over the same time period, with nearly 4.6 million prescriptions dispensed in 2016.
“With every new partner we add to the NJPMP, we’re building a broader, stronger network more capable of combatting prescription drug abuse and diversion,” said Attorney General Christopher S. Porrino, who oversees the Division of Consumer Affairs, which operates the database. “Prescribers and pharmacists in our new partner states have joined thousands of professionals nationwide who are reaching beyond geographical boundaries to present an allied front against the scourge of addiction.”