In response to the rising rate of drug overdose deaths, 49 states had a Prescription Drug Monitoring Program (PDMP) by 2014. By requiring physicians to report all prescriptions for controlled drugs, and to consult the database before prescribing, state agencies hoped to stop “doctor shopping,” writes John Lilly, M.B.A., D.O., in the summer issue of the Journal of American Physicians and Surgeons.
Opioid-related death rates have been rising since 2000, Dr. Lilly notes, with no noticeable decreases with the establishment of more PDMPs. This is not surprising, since doctor shopping (obtaining prescriptions from more than one doctor) was the source of only 2.5 percent of misused pain medicine in 2017. About 85 percent of misused prescriptions came from one doctor, and 12.5 percent did not go through a doctor.
In the four years that could be compared, doctor shopping actually increased after the PDMP was established, Dr. Lilly writes.
“The ‘opioid crisis’ is the increase in deaths due to illicit fentanyl, from 2,128 in 2014 to 24,524 in 2017,” Dr. Lilly states: “PDMPs have no effect on illicit fentanyl. The real cause of increased overdose deaths in the last four years is not doctor shopping, but the surge of illicit fentanyl coming from China and Mexico.”
While PDMPs cannot and do not achieve their ostensible purpose of stopping misuse of opioids, they do create a national prescription database. This might be their true purpose as well as their effect, Dr. Lilly suggests. The Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties since 1943.
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