Opposition to a requirement making it obligatory for providers to review prescription drug monitoring programs before prescribing opioids could snag efforts to pass comprehensive legislation to combat the opioid abuse epidemic.
The requirement was included in the Senate version of the proposed Comprehensive Addiction and Recovery Act (PDF), which made state grant funding toward establishing a plan for a “comprehensive opioid abuse response” contingent upon requiring providers to access state PDMP databases prior to prescribing opioids.
But a conference committee version of the bill released on Tuesday changed the requirements. It said states “may,” not “shall,” use the funding toward their establishing or maintaining a prescription drug monitoring program. The provision now reads that states “may allow all individuals authorized by the State to write prescriptions for schedule II, III, or IV controlled substances to access the prescription drug monitoring program of the State.”
The change would eliminate making it mandatory for physicians to check the database before writing prescriptions for opioids. The databases are designed to help physicians identify patients who visit multiple doctors to get multiple prescriptions for the painkillers.
Critics of the changes have raised concerns that making the review of PDMPs voluntary instead of mandatory would lessen the efficacy of such programs in tracking opioid prescribing rates and put more patients at risk.
“These PDMPs are important because they help doctors spot early signs of addiction, such as doctor-shopping,” wrote Gary Mendell, founder and CEO of the anti-addiction advocacy group Shatterproof in a blog post published in the Huffington Post on Tuesday. “They also prevent physicians from accidentally prescribing a drug that could be lethal in combination with another the patient is taking.”
Forty-nine states have PDMPs, but only 16 require opioid prescribers to check their databases before prescribing opioid pain medications to patients.
Recent studies have provided evidence supporting the effectiveness of state monitoring programs in lowering opioid prescribing rates. A study published last month in Health Affairs found PDMPs led to a more than 30% decline in prescribing Schedule II opioids by physicians, and that the decline was maintained after three years.