Patients, Privacy, and PDMPs: Exploring the Impact of Prescription Drug Monitoring Programs

Patients, Privacy, and PDMPs: Exploring the Impact of Prescription Drug Monitoring Programs

https://www.cato.org/events/patients-privacy-and-pdmps

Featuring David S. Fink, MPhil, MPH, Mailman School of Public Health, Columbia University; Kate M. Nicholson, JD, Civil rights attorney and pain patient advocate; Nathan Freed Wessler, JD, Staff attorney, ACLU Speech, Privacy, and Technology Project; Patience Moyo, PhD, Assistant Professor, Brown University School of Public Health; moderated by Jeffrey A. Singer, MD, Senior Fellow, Cato Institute.

Prescription drug monitoring programs (PDMPs) operate in all 50 states and the District of Columbia. These statewide electronic databases of prescriptions dispensed for controlled substances were established in response to the opioid overdose crisis. Their purpose is to facilitate drug diversion investigations by law enforcement, change prescribing behavior, and reduce “doctor shopping” by patients who seek drugs for nonmedical use. In 28 states it is mandatory for providers to access the database and screen each time before prescribing any controlled substance to any patient. There is evidence that PDMPs have contributed to the dramatic 42 percent decline in prescription opioid volume since 2011. Many healthcare practitioners cite the inconvenience and workflow disruptions of mandatory-access PDMPs as deterrents to prescribing, while others fear scrutiny from law enforcement and licensing authorities — even for appropriate medical prescribing. This is unintentionally causing the undertreatment of patients with acute and chronic pain and, in some cases, the abrupt withdrawal of treatment from chronic pain patients. There is also evidence that PDMPs increase crime by driving nonmedical users from diverted prescription opioids to more harmful heroin and fentanyl, thus fueling overdoses. Finally, PDMPs pose a serious risk to medical privacy by allowing law enforcement to access confidential medical records without a warrant based on probable cause, which may be in violation of the Fourth Amendment.

An expert panel will examine the positive and negative effects of PDMPs on patient care, patient privacy, the overdose rate, and crime, hoping to learn whether they do more harm than good.

To register to attend this event, click a button below and then submit the secure web form by noon EDT on Wednesday, October 2, 2019. If you have any questions pertaining to registration, you may e-mail events@cato.org.

2 Responses

  1. If most state PDMP systems work anything like the Oregon PDMP, then there are serious flaws in the system that need to be corrected. I personally check the PDMP everyday for the patients that I will be seeing that day. Oregon state law does not require that I use the PDMP, only that I am registered to use the system (big mistake). The law allows providers to enroll staff members to access the system for them, but too few are using it. It will take laws and fines before more of the providers that SHOULD be using the system before EACH AND EVERY PRESCRIPTION is written start doing so. With regular use of the PDMP, I have found the various mistakes made just on my panel of patients, which means that statistically there are THOUSANDS of these errors and more occurring within the PDMP system daily.
    — misspelled names, wrong dates of birth, wrong addresses
    — incorrect dates entered for filled dates and prescribed dates
    — incorrect medications and dosages and quantities
    — incorrect MED calculations
    — incorrect pharmacies identified
    — NO provider identified as being the prescriber
    — a hospital listed as the prescriber, not an actual person
    — failure to list medications being filled when state law requires such mandatory reporting within 72 hours — I have had prescriptions fail to show up even after a full year (notably the Roseburg Safeway)
    — failure of the Oregon Board of Pharmacy (OBP) to take these errors seriously and actually investigate and fine these pharmacies for their continued omissions and failures to correct in a timely manner — basically it shows that the OBP and the pharmacies are more interested in monetary profits than patient centered care and regulations
    — the PDMP office declares that they cannot take action against pharmacies for these errors and the OBP fails to do so to protect their own pharmacy members
    — I still see urgent care centers and ER’s failing to check the PDMP before giving out pain medications to patients that have current opiate prescriptions, yet the medical records at these facilities FAIL to note those current prescriptions; so they just give them more. If you have a good story (and more importantly, the right insurance), you will get pain medication. If you claim low back pain and have Medicare or Oregon Health Plan, you will be highly suspected to be a “drug seeking” patient and kicked out as fast as they can do so.
    — the system is broken and needs work. The PDMP and the OBP need to investigated for failing to do their jobs.

  2. They are so scared its not funny. My PCP retired & I will need to see the younger Dr. Im ttirating off methadone& the Tenzapam help me sleep.
    I pray this new Dr will not cut me off cold Turkey!
    I’m 64 /almoat 65& pray he doesn’t cut me off. I understand that he is smart enough to know this!

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