Of all the ways drug addicts can get their hands on narcotics, the most preventable is from doctors who can — but don’t — check the patient’s history with controlled substances before authorizing more.
The Nevada Board of Pharmacy maintains a database, as required by law, listing the names of people who have been prescribed narcotics such as Lortab, OxyContin, Percocet and Vicodin. Physicians have been encouraged to check the database before prescribing a narcotic to a patient to make sure the patient isn’t already being prescribed narcotics from another doctor.
One of the reasons doctors should check a patient’s history, as reporter Megan Messerly pointed out in last week’s issue of The Sunday (“We Have a Pill Problem”), is that many addicts go to multiple doctors feigning pain to get prescriptions for narcotics, which are regulated by the Drug Enforcement Administration. The practice is known as “doctor shopping” — addicts’ efforts to get as many doctors as possible to prescribe drugs. Some may not use the drugs themselves but sell them on the street. (A 30 mg tablet of black-market OxyContin sells for about $20 on the street, according to the DEA.)
Given the pharmacy board’s database, why are so many addicts still able to secure narcotic scripts from multiple physicians? The answer triggers great disappointment: Of the 9,150 physicians in Nevada authorized by the pharmacy board and the DEA to prescribe narcotic medications, barely half, 5,037, have registered to consult the database. And less than half of those, 2,100, use it regularly.
In other words, odds are an addict can go to multiple doctors, claim pain and receive multiple prescriptions from inattentive physicians, then fill them at various pharmacies. The so-called patients are gaming the system, but doctors are complicit by their inaction.
Thankfully, this problem now should be fixed. A law passed by the 2015 Nevada Legislature took effect Oct. 1, making it mandatory that physicians who have the ability to prescribe narcotics check the database to see if the patient seeking a prescription is trying to defraud the system, as evidenced by multiple, overlapping prescriptions for controlled substances. A physician who doesn’t use the database could be disciplined.
Pharmacists also have access to the database, to report when they dispense prescriptions and to help them stop addicts from pharmacy shopping. The pharmacists’ input also is valuable because a prescribing doctor can search for his own name to see if fraudulent prescriptions are being issued by someone forging his signature.
We wish doctors who have the authority to prescribe narcotics would have been using the database all along, to cut down on the incidence of people getting multiple prescriptions for controlled substances. They are among the most dangerous medicines that can be prescribed and are the ones most likely to be abused.
Now that there’s a law that requires doctors to check the pharmacy board’s database to make sure a patient isn’t already getting drugs elsewhere, we expect all physicians will get on board, lest they become lawbreakers themselves. It’s not the best motive to participate in the database, but if it works, it works.
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