The opioid epidemic killed more than 1,300 Texans in 2016. The next year, state lawmakers passed legislation to mandate a prescription-monitoring program that requires medical providers to check a patient’s health records before prescribing opioids. The mandate is supposed to take effect in September, but the program may be delayed at the request of doctors.
To understand why monitoring prescriptions can help reduce opioid abuse, all you need to do is listen to the stories of people who’ve struggled with addiction.
Tanis Rutherford, a registered nurse in San Angelo and former opioid addict, says a drug-monitoring program could have made all the difference for her eight years ago.
“I started having problems with my hip. I went to see my doctor, and so he started giving me Lortabs [a prescription opioid]. And after being on them for a period of time, it felt like they just didn’t work as well. So I would take two,” Rutherford says. “I started travelling. He said, ‘I’ll just send you the prescription in the mail.’ I used to get 90 a month, and he upped it to 120.”
She says she hit rock bottom with an overdose in 2016.
“I had 60 Xanax, I had 120 Lortabs, I had like 60 antidepressants and my thyroid medicine, and I took about – I guess it was about – 400 pills," she says.
All those pills were legally prescribed to her, she says.
Rutherford’s story is not unique. Overprescription of painkillers is a driving factor in the U.S. opioid epidemic. That’s where the drug-monitoring program comes in. The goal is to lessen rates of addiction and overdoses by making doctors aware of how many painkillers their patients are prescribed.
But some Texas doctors are pushing to slow down the process.
Dr. Debra Patt, executive vice president of Texas Oncology, said there are concerns that doctors aren't "optimally ready."
Patt, who serves on the Texas Medical Association's Council on Legislation, said doctors support the prescription-monitoring program, but the technology isn’t there to make it easy to implement. She said the program, as it's proposed, will add about five minutes per prescription, and that adds up for doctors who already have busy schedules.
She wants to see an easily accessible database that’s integrated with other health records.
“That way when I see a patient, if I write for a controlled substance, I don't have an additional five-minute process, by opening up another system,” she says.
The data systems that track drug prescriptions can have a big impact on these programs’ effectiveness. When Massachusetts implemented its prescription-monitoring program in 2016, it also invested in new software, said Dr. Monica Bharel, commissioner of the Massachusetts Department of Public Health.
“Now, within a few clicks, a prescriber can get to the information,” she says. “We’ve now started to integrate this into the electronic medical record, so it’s really part of the clinical flow.”
She said from 2016 to 2017, Massachusetts saw a 35 percent drop in the number of schedule II opiates – such as OxyContin, Percocets and codeine – being prescribed. The state also saw an 80 percent decrease in what’s known as “doctor shopping” or patients using multiple pharmacies to get opioids.
But that success wasn't cheap. Bharel says it cost $2.7 million to develop new prescription-monitoring software in Massachusetts. In Texas, Patt said she’d like pharmacies to help foot the bill.
In the meantime, the Texas Medical Association is hoping to get an extension on the deadline this legislative session.
“TMA is working with the Legislature today to try to come to a reasonable compromise,” she says.
But Rutherford says the longer the state waits to implement the monitoring program, the more people will fall into addiction.
“I can’t believe they don’t already have it already in place,” she says. “I’m just surprised that it’s taken this long to do it. It’s almost like we’ve waited until it’s out of control.”