- California physicians and prescribers must query the state’s prescription drug monitoring program (PDMP) before prescribing opioids or other controlled substances, according to newly-passed state legislation.
The new law is part of an effort to combat the opioid epidemic and promote safer prescribing practices across California.
Prescribers will need to search for patient health data in California’s Controlled Substance Utilization Review and Evaluation System (CURES) before prescribing controlled substances to patients for the first time. Healthcare providers are also required to check the PDMP once every four months for patients continuing treatment on a long-term basis.
While California has had an electronically-accessible prescription drug database in place since 2009, less than 10 percent of providers were using the database as of 2012.
This newest piece of legislation will help to significantly increase the number of providers in the state utilizing the resource to access relevant patient health information.
California is the 28th state to mandate that providers check PDMPs before prescribing opioids. Other states that require providers to consult PDMPs include Arizona, Wisconsin, Ohio, Texas, Oklahoma, Florida, New York, Pennsylvania, and others.
Bill co-sponsors include Consumer Attorneys of California, California Narcotics Officers Association, and patient advocacy groups Shatterproof and Consumer Watchdog.
“Without a law requiring them to, doctors were not reviewing patients' histories before prescribing these powerful narcotics,” said Consumer Watchdog Executive Director Carmen Balber. “After six long years of roadblocks and delays manufactured by the California Medical Association, California is finally back on the front lines of the fight against opioid addiction.”
“It should not have taken so long, but today's action will help ensure that doctors have the information they need to safely prescribe, manage opioid dependence and prevent addiction,” she added.
Federal entities including CMS have named curbing opioid overprescribing a top priority in 2018. The agency released an opioid roadmap in June urging healthcare providers to leverage patient health data available through PDMPs to monitor patient use of prescription opioids and watch for doctor shopping.
By requiring providers to consult the state PDMP before prescribing, California is taking steps to better understand opioid use patterns for well-informed prescribing.
“I know this CURES mandate will save lives, and I am thankful to all who have brought this day to fruition,” said one California resident affected by the opioid crisis.
According to the Department of Public Health, 1,882 people died of opioid overdoses in California in 2017. Additionally, more than 4,281 people were treated for non-fatal overdoses and other opioid-related ailments in California emergency rooms last year. Prescription opioids are the most common cause of opioid overdoses in the state.
Other states have also recently made efforts to boost PDMP use in recent months. In March, New York’s PDMP achieved interoperability with PDMPs in 25 other states and Washington, DC.
The New York Department of health assisted in enabling interoperability between New York’s PDMP and others to improve patient prescription data exchange between programs. New York providers now have secure access to nearly 150 million patient’s controlled substance history.
New York providers can also search the PDMP for patient health records from any participating state. Improving provider access to patient prescription data will allow providers to more easily identify patients who may be visiting multiple doctors for several prescriptions or misusing prescription drugs.
While PDMP use has been touted as a way to promote safer prescribing practices, a JAMA Surgery study by researchers at Dartmouth-Hitchcock Medical Center found PDMP use may negatively affect clinical efficiency without offering much benefit as a tool for reducing opioid prescribing for patients undergoing elective surgical procedures.
PDMP use can be effective in outpatient care settings and for patients with chronic pain, but it is unnecessarily burdensome for providers delivering elective surgical procedures, researchers maintained.
Researchers advised that future legislation intended to curb opioid overprescribing be designed with the clinical workflows of surgical clinicians in mind.