20 percent of prescribers use monitoring program

PROVIDENCE, R.I. (AP) — Only 20 percent of those allowed to prescribe controlled substances in Rhode Island are using a 15-month-old drug monitoring program that aims to help prevent abuse of the medications, a top state health official said Tuesday.

Dr. James McDonald, chief administrative officer of the Board of Medical Licensure and Discipline, called the state’s Prescription Monitoring Program a powerful clinical tool and said it’s not being used nearly enough.

“It’s currently not being used the way it could be, or should be,” he said. “We really need 95 to 100 percent to sign up.”

McDonald’s comments came at a Statehouse meeting of a special commission created by the legislature to look at ways to curb prescription drug abuse.

The monitoring program in Rhode Island was created in September 2012 and was expanded this year to include Schedule IV drugs, in addition to Schedule II and III drugs. Those include opiates, benzodiazepines and stimulants.

Of the 500 top prescribers of controlled substances in the state, 52 percent are internal medicine doctors and 21 percent are in family practice, according to data presented at the meeting. Sixteen percent are psychiatrists.

McDonald said both he and Health Department Director Michael Fine have been reaching out to health professionals and hospital CEOs since the registry launched to encourage more to use it. McDonald said he sent letters to about 40 percent of the top 200 prescribers who were not registered, after which most of them did.

About half of hospital pharmacies in the state are registered.

But both McDonald and Fine conceded there are drawbacks to making registration mandatory, and they’re not calling for that to happen.

“Nobody likes compulsion, and we’d much rather get there by voluntary compliance,” said Fine, who is a member of the commission.

The monitoring program isn’t presently integrated with electronic medical records. Fine said use could be boosted if there’s a single sign-on that providers can use to access all of a patient’s information.

Fine said there has been a slight drop in prescription drug overdoses since the system was implemented, but that the number of IV drug overdoses has risen. More than 180 Rhode Islanders died from unintentional drug overdoses last year.

McDonald stressed the state doesn’t want to get in the way of doctors treating legitimate pain, it simply wants to be able to better track drug misuse, including by patients “shopping” for prescriptions with various doctors. For instance, the registry can track how many people have gone to five or more pharmacies or providers.

“We’re not trying to be Big Brother,” he said. “A balanced approach, we think, is sensible.”

The commission, led by state Rep. William O’Brien, D-North Providence, is expected to report its findings back to the General Assembly by April 1.

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