Indiana Public Media | By Sarah Fentem | November 22, 2017
Right now, only dispensers — such as pharmacists — are required to put information into the INSPECT system when they fill a controlled substance prescription.
An Indiana lawmaker wants the state to take the next step toward making Indiana’s drug database more effective at preventing opioid addiction.
Fourteen states currently require both physicians and pharmacists to check someone’s prescription history before dispensing certain powerful medicines, but Indiana isn’t one of them.
Sen. Jim Merritt (R-Indianapolis) said Tuesday he’s authoring a bill that would require all practitioners dispensing or prescribing controlled substances — such as oxycodone or other painkillers — to register with the Indiana prescription drug database, called INSPECT.
Such databases alert providers to patient risk factors, such as a history of drug use or so-called “doctor shopping,” in which someone sees several doctors to get multiple prescriptions.
Right now, only dispensers — such as pharmacists — are required to put information into the INSPECT system when they fill a controlled substance prescription. Merritt says ultimately the goal would be a mandatory database check for all providers, but said he advocates taking an “incremental approach.”
“Once they have the tools, they will know when someone has had an overdose, when someone is pill shopping,” said Sen. Merritt.
Indiana State Medical Association President John McGoff agreed getting people registered is a logical first step.
“You’d have to get people registered before they can query it, but I think it is very, very useful information that they’ll have at their disposal,” he said at the Statehouse today during a press conference with Merritt.
Patrick Knue, Director of the Prescription Drug Monitoring Program Training and Technical Center at Brandeis University, said estimates show only one-third of authorized users actually check a prescription drug monitoring program.
“With the opioid epidemic, a number of states passed legislation requiring they register or get an account or require them to use [the PDMP] under certain conditions,” he said. “it varies across the country, but typically mandatory registration increases usage of the database.”
Not surprisingly, Knue said a mandated compliance is the most effective way to get people to check the database. Such is the practice for Indiana neighbor Kentucky’s KASPER database, which prescription monitoring specialists have called “the gold standard for prescription drug monitoring programs.”
Research says KASPER has cut down on inappropriate opioid prescriptions in certain populations. According to a recent review of workers’ compensation claims by the independent Workers Compensation Research Institute, the number of workers with comp claims given opioids decreased from 54 percent to 44 percent after checks became mandatory.
“If you’re not using it, it’s not doing you any good or doing your patients any good,” said Knue.
In August, Indiana started integrating INSPECT data into electronic health records — a move McGoff said will also make it easier to check for suspicious behavior from patients.
“It will literally be one click, and information will be instantly available,” he said.
This story was produced by Side Effects Public Media, a reporting collaborative focused on public health.