Tex. Doctors, Pharmacists to Use Tracking Tool for Opioid Prescriptions

Tex. Doctors, Pharmacists to Use Tracking Tool for Opioid Prescriptions

News Jan 08, 2018

San Antonio Express-News

Jan. 08—AUSTIN—Spurred by the national opioid crisis, Texas is joining the majority of states that require medical providers to check patients' prescription history before giving them powerful painkillers that can be highly addictive.

Lawmakers hope that mandating use of the state's prescription monitoring program will reduce drug abuse in Texas, where more than 2,500 people died from overdoses in 2015, according to federal data.

"We should be a part of trying to work with our state and those people who are impacted by this crisis to be able to do something to help them and bring the problem into control," said Rep. Senfronia Thompson, D-Houston, sponsor of House Bill 2561 that was signed into law last year.

The mandatory checks, however, don't take effect until September 2019. Proponents sought the two-year delay to give pharmacists and physicians time to learn the system.

"We want to make sure that ... it's rolled out very effectively," said Chris Wallace, president of the Texas Association of Business, which supported the bill. "That is why waiting is going to be better in the long run."

Texas is one of roughly a dozen states that doesn't already mandate use of the drug-tracking databases, which can help identify over-prescribing and so-called doctor shopping among patients.

The Lone Star State created its prescription monitoring program more than three decades ago, but only a portion of eligible providers are using it, according to Allison Benz, executive director of the Texas State Board of Pharmacy.

That number has grown, however, since the pharmacy board recently took over the database from the Department of Public Safety, a law enforcement agency, and made it more user-friendly.

Over the last year, the number of provider searches has risen, while the amount of prescriptions dispensed for opioids and other powerful drugs declined slightly, according to data from the pharmacy board.

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"It's a far better tool than it's ever been in the past and it's only getting better," said Dan Finch, legislative affairs director for the Texas Medical Association. "More and more physicians will use it whether or not there's a mandate, because it's providing useful information for the treatment of their patients."

Rob Phelps, the pharmacist in charge at Rite-Away Pharmacy in San Antonio, said staff already check the database, especially for new patients, those who show up erratically or if something seems off. Recently, a pharmacist there elected not to fill a patient's prescription "just yet" after searching the database and seeing it was too soon, Phelps said.

"By and large we're already checking it. If I have any whiff of a suspicion then I check it, and I encourage the other staff pharmacists to do the same thing," said Phelps, who questioned the need for a blanket mandate. "That is basically telling us how to practice and I am sure the physicians are going to be as unkindly opinionated to that as am I."

Bexar County in 2015 had one of the highest rates of opioid-related overdose deaths in the state, with more than 100 fatalities that year. But since a peak in 2012, opioid prescribing rates have fallen in Bexar County, a trend mirroring that at the state and national level, according to federal data.

Under the mandate, pharmacists and physicians in Texas will have to look up a patients' prescription history before giving them opioids, benzodiazepines, barbiturates or carisoprodol. The checks won't apply when patients have cancer, or are in hospice care.

Those carve-outs could change, however, before the law even takes effect. A legislative committee is set to study the prescription monitoring program over the coming months and make recommendations for the next Legislative session, which begins at the start of 2019.

Meanwhile, other states are beefing up their prescription monitoring programs by adding more information, such as law enforcement reports on drug-related arrests or overdoses. The more data, the better able medical providers are able to flag people at risk of addiction who can be directed to treatment, said Patrick Knue, director at the PDMP Training and Technical Assistance Center.

"The PMP's are just another tool ... not any of them are going to be the end all, be all of solving the drug problem," he said. "Ultimately, it boils down to folks in the health care community having enough information to provide proper treatment."

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