37 states currently have PDMP’s, or Prescription Drug Monitoring Programs. These PDMP’s are a very useful tool for dentists everywhere. This allows us to unite with our fellow professionals, pharmacists, MDs and other potential prescribers to create a unified front to battle the opioid crisis. The NAMSDL website identifies that these programs were created to “address prescription drug abuse, addiction and diversion,” but additionally they have the added benefits of helping to identify at risk clinics, help provides with more information, and even help spread public health initiatives about abuse trends.
Despite having such resources available, the use of these programs is not as prevalent as it should be. A Johns Hopkins study conducted in 2014 showed that only one out of four primary care physicians were aware that this program existed in their state. Of those that used the resource, approximately half used it regularly and felt that it contributed to decreasing the rate of abuse of prescription drugs.
For me, this tool allows me to remove blinders that I had on previously. Without the help of the Colorado PDMP, I was guessing. As many who work in dental offices know, drug seekers are a bit of a phenomenon in the office. If someone is labeled as a drug seeker by any professional, things change for that person. In example, I offer a story at an office I worked a locum tenum position at. A 45 year old mother of two with tattered clothes walked into our clinic and immediately I saw my staff’s face change. There was an exchange at the front desk and I immediately went out to see what the problem was. When pulling my receptionist aside, she informed me that this patient was a “frequent flier” and the regular doctor had deemed her a “drug seeker.” As her two kids played in our play area, I saw the swelling on the side of her face and the pain she seemed to be in. I informed the receptionist that drug seeker or not, if she was our patient, we could not deny her care. I saw her for an emergency exam and diagnosed an abscessed and non-restorable #31.
I am a member of the Colorado PDMP but the doctor whose office I was covering was not. The office was not even aware of the PDMP program. Upon looking up her information, I saw that the last time she was given a prescription for narcotics was in 2012, almost 5 years ago. When I spoke to her, I learned that she was not interested in drugs. She just wanted to get out of pain. Upon extracting the tooth, she herself refused any pain prescription before I even had a chance to breach the subject. She said Ibuprofen was sufficient.
There are an estimated 36 million prescription pain abusers worldwide, but that day my patient was not one of them. And the only way I knew that for certain was by using my PDMP to gain data. Otherwise, it is the fine art of judging a book by its cover and for this we are often wrong. Instead of playing the guessing game, the PDMP allows us to work off of facts. The PDMP just as easily allows me to find drug seekers and start solving the problem of prescription pain medications at the source: the prescription.
PDMP’s have their challenges. For one, their user interface is challenging. They are not user friendly and they can be counter intuitive. They are a challenge to maneuver and find info on. There is also a lack of good training and educational resources on how to use them effectively. This is perhaps one of the reasons why so few practioners use them regularly. I urge those in charge of making the programs to fix these issues but in the interim, despite these challenges, not using them can mean the difference between life or death for our patients.
According to the website, the following states have the programs:
Alabama, Arizona, California, Colorado, Connecticut, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Mississippi, Nevada, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, West Virginia, and Wyoming.
Eleven states (Alaska, Arkansas, Delaware, Georgia, Maryland, Montana, Nebraska, New Jersey, South Dakota, Washington, and Wisconsin) and one U.S. territory (Guam), have enacted legislation to establish a PDMP, but are not fully operational.
If your state is one of the ones that has a PDMP, sign up today. If your state does not, talk to your local representation to help change that. The opiod crisis is in part our responsibility as dentists. Your prescription can change someone’s life. Realize that power and use the resources you have to prescribe responsibly and effectively.
Despite having such resources available, the use of these programs is not as prevalent as it should be. A Johns Hopkins study conducted in 2014 showed that only one out of four primary care physicians were aware that this program existed in their state. Of those that used the resource, approximately half used it regularly and felt that it contributed to decreasing the rate of abuse of prescription drugs.
For me, this tool allows me to remove blinders that I had on previously. Without the help of the Colorado PDMP, I was guessing. As many who work in dental offices know, drug seekers are a bit of a phenomenon in the office. If someone is labeled as a drug seeker by any professional, things change for that person. In example, I offer a story at an office I worked a locum tenum position at. A 45 year old mother of two with tattered clothes walked into our clinic and immediately I saw my staff’s face change. There was an exchange at the front desk and I immediately went out to see what the problem was. When pulling my receptionist aside, she informed me that this patient was a “frequent flier” and the regular doctor had deemed her a “drug seeker.” As her two kids played in our play area, I saw the swelling on the side of her face and the pain she seemed to be in. I informed the receptionist that drug seeker or not, if she was our patient, we could not deny her care. I saw her for an emergency exam and diagnosed an abscessed and non-restorable #31.
I am a member of the Colorado PDMP but the doctor whose office I was covering was not. The office was not even aware of the PDMP program. Upon looking up her information, I saw that the last time she was given a prescription for narcotics was in 2012, almost 5 years ago. When I spoke to her, I learned that she was not interested in drugs. She just wanted to get out of pain. Upon extracting the tooth, she herself refused any pain prescription before I even had a chance to breach the subject. She said Ibuprofen was sufficient.
There are an estimated 36 million prescription pain abusers worldwide, but that day my patient was not one of them. And the only way I knew that for certain was by using my PDMP to gain data. Otherwise, it is the fine art of judging a book by its cover and for this we are often wrong. Instead of playing the guessing game, the PDMP allows us to work off of facts. The PDMP just as easily allows me to find drug seekers and start solving the problem of prescription pain medications at the source: the prescription.
PDMP’s have their challenges. For one, their user interface is challenging. They are not user friendly and they can be counter intuitive. They are a challenge to maneuver and find info on. There is also a lack of good training and educational resources on how to use them effectively. This is perhaps one of the reasons why so few practioners use them regularly. I urge those in charge of making the programs to fix these issues but in the interim, despite these challenges, not using them can mean the difference between life or death for our patients.
According to the website, the following states have the programs:
Alabama, Arizona, California, Colorado, Connecticut, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Mississippi, Nevada, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, West Virginia, and Wyoming.
Eleven states (Alaska, Arkansas, Delaware, Georgia, Maryland, Montana, Nebraska, New Jersey, South Dakota, Washington, and Wisconsin) and one U.S. territory (Guam), have enacted legislation to establish a PDMP, but are not fully operational.
If your state is one of the ones that has a PDMP, sign up today. If your state does not, talk to your local representation to help change that. The opiod crisis is in part our responsibility as dentists. Your prescription can change someone’s life. Realize that power and use the resources you have to prescribe responsibly and effectively.