Minnesota Targeting Painkiller Abusers
Facing an epidemic of abuse, Minnesota is now tracking
prescriptions such as Vicodin and OxyContin to prevent doctor-
shopping.
By JOSEPHINE MARCOTTYmarcotty@startribune.
com
Last update: January 6, 2010 – 8:26 PM
It’s a dilemma doctors face all the time. A new patient claims to be in serious pain and
asks for Vicodin or OxyContin. Is the pain real or is the patient an addict?
Now, a new, controversial statewide database is supposed to help them figure that out.
Starting this week, pharmacies are required to collect patient and doctor information on
every prescription they fill in an effort to address the national epidemic of painkiller
abuse. According to state estimates, 117,000 Minnesota adults abuse prescription drugs
every year.
When it’s fully up and running in March, the database will allow Minnesota doctors and
pharmacists, for the first time, to check whether patients are getting too many
prescriptions for the same narcotics from different providers. Also known as doctor-
shopping, it’s a way for addicts to feed their habit without tipping off individual
physicians or pharmacies.
But Minnesota doctors are divided over the new registry. Some, like emergency room
doctors, are relieved that they now will have a way to be sure they are not simply feeding
someone’s habit. But others say it will scare doctors into writing fewer needed
prescriptions for fear of being investigated by law enforcement or professionally
disciplined.
“Physicians are very squeamish about prescribing and being scrutinized,” said Dr.
Miles Belgrade, a pain specialist at the University of Minnesota Medical Center who
testified against the proposed plan at the Legislature in 2007.
Even drugs for pets
Minnesota is the 34th state to monitor prescriptions for controlled substances such
as amphetamines, barbiturates and even some diet pills. The database, funded with a
$400,000 federal grant, will track more than 1 million prescriptions per year.
Under the law, almost every Minnesota pharmacy that provides controlled
substances now must submit the name and address of the patient — and even the name
of the animal if it’s for a pet — the name of he prescriber and the pharmacy that fills it.
Doctors will be able to check the Minnesota Prescription Monitoring Program database
when they doubt a patient’s story, said Cody Wiberg, executive director of the Minnesota
Board of Pharmacy, which manages it. They can see, for instance, whether the patient has
filled five prescriptions for Vicodin at five different pharmacies in the past two weeks.
That’s the kind of information that Fairview Health System discovered when it looked at
patient charts from several of its hospital emergency departments.
“We would see people going from one hospital to the next on the same day and on
the next day and not telling the second and third doctor about the other visits,” said
Susan Van Pelt, director of quality improvement for Emergency Physicians
Professional Association, a doctor group that staffs some of Fairview’s emergency rooms.
Getting help for abusers
With the database, doctors can make a more informed decision about the patient, Wiberg
said. The main goal, he said, is to help patients, not catch criminals.
“We’re hoping that somewhere along the line, a health professional is going to intervene
and try to get this person the help that they might need,” Wiberg said. Some might be
addicts who need treatment, and some might be people with under-treated chronic pain
who need the help of specialists.
The law that created the database is designed to keep out those who just want to find
wrongdoers. The government is prohibited from using it to check on doctors’ p
rescribing habits for fear of discouraging them from prescribing painkillers to people
who really need them, said Robert Leach, executive director of the Minnesota Board of
Medicine.
“We didn’t want … to have a chilling effect on the treatment of pain,” he said.
But Belgrade says that the chilling effect still could be a problem. “The law may say that,
but that and the psychological effect on physicians are two separate things,” he said.
Other states have found that the number of prescriptions declined after they began
monitoring prescriptions. But no one knows if that’s because it worked as intended or if
doctors simply wrote fewer of them.
The law also states that criminal investigators must have a search warrant or a court-
ordered subpoena to access the database, but that, too, is of little comfort to Belgrade.
“I don’t know how hard it is to get a subpoena,” he said.
Staff writer Maura Lerner and the Associated
Press contributed to this story. Josephine
Marcotty • 612-673-7394
