The Ultimate Guide to Prescription Drug Abuse

The Ultimate Guide to Prescription Drug Abuse: The Problems and Solutions

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  • LEARN MORE  about how every 4 minutes someone is sent to treatment
  • HELP STOP  doctor shopping and diversion
  • DISCOVER  how the current administration says it will reduce drug use by 15%

Everything You Need to Know About Proposition 46

Election day is right around the corner!

It is just one week away….

California residents are most likely already aware of Prop 46, which is the most hotly debated and contested ballot initiative this year.

For those outside of California, it is still an interesting debate to follow.

So what is Proposition 46?

It is a ballot initiative in California that addresses several health care reforms.

There are actually three different initiatives all rolled into one.

1) Increase the limit on damages for pain and suffering.

▪ The projected raise on medical malpractice suits would go from $250,000 to $1.1 million. This is the cap on the amount of damages for pain and suffering that can be awarded in a medical malpractice lawsuit. The cap would be indexed to inflation in subsequent years.

2) Require random drug and alcohol testing of doctors.
▪ Hospitals administrators would conduct random drug and alcohol tests to doctors affiliated with the facility. Subsequently, the state medical boards must take specific disciplinary action, including license suspension, if a doctor is found to have been using drugs or alcohol on duty or refuses to follow the drug and alcohol testing protocol.

3) Mandate that health professionals consult a statewide drug database – known as CURES – before issuing certain medications to patients to prevent “doctor shopping.”
▪ All health professionals, including pharmacists, would have to check the statewide prescription drug monitoring program (PDMP) before dispensing potentially abusive drugs to a patient for the first time.  The CURES system can determine if the patient already has an active prescription with other physicians or at other hospitals.

As mentioned before, this Proposition has become the most hotly debated and contested initiative. Thus far, supporters have raised $9.2 million and spent $7.4 million, while opponents have raised $57.6 million and spent $54.2 million.  The majority of financial supporters include trial lawyers, attorneys, and consumer watchdog groups.  The opponents include the California Medical Association and every other group representing doctors in California, as well as all of the major Insurance companies.
At this point, it seems unlikely that Prop. 46 will pass. Most of the major newspaper in the state, including the Los Angeles Times and Orange County Register, have lined up against the measure.

According to the Legislative Analyst’s Office, raising the malpractice cap would likely increase total health care spending by 0.1 percent to 0.5 percent. For state and local government, it said the increase could amount to “several hundred million dollars annually.”

Why do we oppose Prop 46?

Prop 46 is essentially well-intentioned.  The source of Prop. 46 came from a tragic event – the death of two young children because of a driver high on prescription drugs.  And the father’s efforts to bring this reform bill through the political process is certainly noble.

However, the costs are too onerous on doctors and health systems with the medical malpractice suits.

As for the random drug testing for physicians, it is certainly a good idea, but the design of the execution here is flawed.  They would be required to submit to drug testing 12 hours after a medical error or risk suspension. But complications from malpractice can take weeks, even years, to appear. It will create another layer of bureaucratic red tape, and will be difficult from an administrative standpoint.

The biggest issue here comes from the mandatory consulting of the PDMP.  The database in California is CURES, or the Controlled Substance Utilization Review and Evaluation System. It has existed in California for over 40 years.

Despite that, currently 5% of all 100,000 California physicians currently use CURES on a regular basis.  It has been the victim of budget cuts almost every year.  There is now one employee to manage the CURES database, for the entire state of California. It has proven to be consistently inaccurate. The data cannot be verified.  The data is not in real-time.  It can take up to 4-6 weeks for a prescription to be entered into the system.  So a doctor shopper could realistically continue to procure drugs without anybody knowing.  CURES is not really a tool for prevention at all.

As always, the issue is that a government built and run system is not going to be an effective system over the long term. It will always be the subject of political debates, budget cuts, and mismanagement.

We need better technology to tackle this highly important issue in the state. A private solution is the only way to really communicate between physicians and pharmacists, to track transactions at the point of prescribing, and to monitor the system effectively.

Check out ScriptGuard at www.scriptguard.com for more information.

 

The Role of Pharmacists in Preventing Prescription Drug Abuse

Pharmacists dispense medications and can help patients understand instructions for taking them.

By being watchful for prescription falsifications or alterations, pharmacists can serve as the first line of defense in recognizing prescription drug abuse.

Some pharmacies have developed hotlines to alert other pharmacies in the region when a fraudulent prescription is detected.

Prescription drug monitoring programs (PDMPs), which require physicians and pharmacists to log each filled prescription into a State database, can assist medical professionals in identifying patients who are getting prescriptions from multiple sources.

Moreover, pharmacists must be vigilant about errors that can occur either from medical mistakes by the physician, a miscommunication between hospital and pharmacy, or a scheming patient who is trying to trick the pharmacist.

They are always be on the lookout for issues that may arise and put their licenses, as well as their pharmacies, in danger.  These issues could include:pharmacist

  • duplicate prescriptions
  • doctor shopping (poly-doctor and poly-pharmacy)
  • drug-drug interactions
  • early medication refills
  • excessive pill counts
  • lack of medical necessity
  • false identifications

To ensure optimal patient outcomes, it is critical that pharmacists have accurate medication history, disease-state information, and provider information for each prescription at their fingertips.

ScriptGuard improves pharmacy work by bridging the communication gap between inpatient and outpatient pharmacy settings.

Here are 4 ways that ScriptGuard can protect a pharmacy:

  • Real-time patient activity report

ScriptGuard eliminates the guesswork, liability, and time required to accurately review a patient’s medication history. Pharmacies need real-time medication and diagnostic information to know the most current list of medications a patient has filled in the past 90 days. ScriptGuard provides that.

  • Risk assessment

The ScriptGuard system will automatically notify a pharmacist if a customer is a risk for doctor shopping or possibly medication abuse.  This enables them to make more informed decisions when dispensing prescriptions.

  • Provider validation

ScriptGuard performs a real-time provider validation that analyzes the prescribing capabilities of all licensed prescribers (MD, DO, NP, PA), which allows pharmacists to avoid heavy fines for filling prescriptions by doctors with expired or invalid credentials. This can also reduce their professional liability.

  • Improved patient safety and treatment outcomes

By avoiding hand written patient lists, relying on an impaired patient’s memory, or endless calls to varied physicians and treating doctors,  pharmacies are free to immediately address patient care. The elimination of wasted time and hours allows them to do their jobs properly and efficiently, and improve the customer experience as well.

 

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