To Tallahassee and Back: How the Prescription Drug Monitoring Program is Doing Today
Since going online, Florida’s Prescription Drug Monitoring Program (PDMP) has proven to be a success. Ten years in the making, the database, which tracks the prescribing of certain controlled substances, has helped save lives, reduce crime and improve patient health and safety.
“Unscrupulous pill mill operators have been put out of business, making Florida as a whole a safer place for all,” states Senator Mike Fasano, the chief sponsor behind the creation of the database. “Figures showing that the number of deaths due to prescription drugs has decreased is the ultimate measure that the PDMP is accomplishing what it was created to do.“
The PDMP, which has been dubbed E-FORSCE (Electronic - Florida Online Reporting of Controlled Substances Evaluation program) is operated within the Florida Department of Health ( headed by Florida’s Surgeon General). Since the program went live 8,345 medical professionals have enrolled in the program. This figure represents 13.5% of Florida-based prescribers who have written a prescription for a controlled substance. Under current law prescribers are not mandated to consult the database. However, both the Florida Medical Association and the Florida Osteopathic Medical Association have encouraged their membership to make consulting the database a routine part of their daily practice.
9,224 pharmacists have been credentialed to access the database since its inception. The burden for reporting prescriptions falls upon the pharmacy that dispenses a controlled substance. Under current law pharmacies have no more than 7 days to report details about controlled substance prescriptions that have been filled. Due to computers and automation, updates normally occur more frequently. This important aspect of the program helps identify patients who may travel from pharmacy to pharmacy in an attempt to fill the same or similar prescriptions from multiple doctors. This practice, known as doctor shopping, is illegal in Florida.
State law allows law enforcement to have indirect access to the database only if an active or ongoing investigation is taking place. Law enforcement is not allowed to randomly consult the database. To date, 734 registered law enforcement officers across the state have been able to obtain information from the PDMP, which has gone a long way towards reducing the diversion of prescription medications.
The PDMP currently does not receive state funding for its operation. When the database was created, a funding arm known as the PDMP Foundation was also created. The purpose of the Foundation is to raise the dollars needed to keep the database continually funded and operational. Federal grants and private donations have kept the program afloat. State law prohibits the use of state dollars or donations from pharmaceutical companies to pay for the PDMP.
Senator Fasano plans to make the ongoing funding of the PDMP a top priority during the 2013 legislative session. He supports lifting the ban on utilizing state dollars and pharmaceutical donations to ensure that adequate funding for the database is available. Additionally, Senator Fasano will work towards requiring prescribers to consult the database before controlled substance prescriptions are written in Florida.
The overall success of the PDMP can be measured by the decrease in deaths with a causal relationship to prescription medications. The Department of Health reports that in 2009 the monthly average number of deaths which involved certain controlled substances was 147.3. In 2011 that number was cut by 19%, due to the implementation of the database as well as more stringent prescribing policies implementing by prescribers.
If you have any questions or comments about state government please post them and I will answer them in an upcoming post. If there is a specific topic you would like me to write about please let me know as well. I look forward to reading about what is important to you!
(Data provided by the Florida Department of Health and the Florida PDMP Foundation was used in this article)
Diane Carlstrom
2:58 am on Friday, October 19, 2012
The pill mills are not closed. Within the last month a Dr in Clearwater prescribed over 700 opiate pills to one patient. These mills close for a short while and reopen elsewhere. In September the DEA clamped down on Walgreens and essentially padlocked the Jupiter distribution center. In 2009 there were a number of stores that dispensed around 100k (some more some less) Oxycodone like drugs and that number dramatically increased to well over 1 million and in one case over 2 million in 2011. You have said just under 14% of the Dr;s writing for these drugs participate in the database- how is that successful? Deaths have decreased since '09 yet distribution of these meds has increased almost 10 fold. I am sorry but I am having a problem linking the two.
Diane Carlstrom
2:58 am on Friday, October 19, 2012
While this plan was put together with good intentions (I am assuming) today it is the patients that are suffering. Smaller pharmacies no longer dispense these drugs and CVS can only dispense very few as the DEA clamped down on them earlier. Walgreens is the pharmacy of last resort for many pain patients and with this latest move it is extremely hard for patients to get their meds there. The drug dealers are doing just fine and are seeing higher profits. Patients in FL don't even have the choice of using medical cannabis as a replacement or to supplement the prescriptions they can't get filled. There are many older people and vets that have been on these meds for years and now find themselves in an involuntary detox. For some people this is very, very dangerous. Plenty of people that take these meds do not abuse them yet these are the people suffering because some Dr's lacking ethics and filled with greed are looking to make a lot of money very fast.
This strategy is not what is saving lives as clearly more drugs have been dispensed as the years have passed. Nice going making the real patients suffer while the same folks keep getting richer.
Mike Chubre
11:43 am on Thursday, October 25, 2012
The prescription drug database is a God send . I can never thank Sen Fasano enough for all his hard work getting this passed. Sen Fasano was only one republican who thought we should have a database and all other reps I talked with were against it . As good as the database is now, I cannot understand why it was not made mandatory for the doctors to use . My guess is Sen Fasano could not get his fellow reps to back him on this. Gov Scott wanted the whole database idea scrapped all together , he said it was a privacy issue . The real problem was not privacy , it was the fact the doctors were against it along with BIG Pharma . Problems with people who need it and are having a hard time getting it are exagerated. I have throughly investigated every aspect of this database and I can tell you , its a God send . Just think if it was mandatory , just how much more lives would be saved and dealers put out of business . The results are already impressive with only a small amount of doctors checking the database. Dealers are going state to state as a result of the new database , so we need a national database just like the state has for checking drivers licenses . Before you vote , ask why the republicans are refusing to get on board 100% with this database and leaving the loopholes for the drug dealers .
Greg Giordano
12:12 pm on Thursday, October 25, 2012
Mike, thank you for your positive comments. You make some excellent points.
It is a well-known fact that It was a heavy lift getting the PDMP legislation passed. It took nine years to overcome the objections that were raised by many members of the legislature and the impacted organizations.
One thing that would surely have kept it from becoming law would have been a mandate that all physicians consult the database. If Senator Fasano had his way that requirement would have been part of the bill which created the PDMP. However, actually creating the database was more important than a requirement that could be addressed in other ways. As I mentioned in the post, Florida's two biggest medical associations have encouraged their memberships to consult the database. Many doctors have reported to our office that they consult the database as a routine matter. It makes good business and medical sense for them to do so.
There is still much to be done to make the PDMP better and more fiscally sound. As long as Senator Fasano is part of the Florida Legislature he will work hard to keep the PDMP vital and well-funded.