PDMP bill supports state information exchange

September 15, 2010

A Congressional bill aims to boost the capacity for information exchange among state programs that monitor prescription controlled substances and seeks to provide continued grant funding to support such efforts.

Key Points

A Congressional bill aims to boost the capacity for information exchange among state programs that monitor prescription controlled substances and seeks to provide continued grant funding to support such efforts.

At present, 43 states have laws that authorize the establishment of prescription drug monitoring programs (PDMPs), which are the statewide databases that are used to track dispensed controlled substances. However, only 34 have programs that are operational, according to the government's Office of National Drug Control Policy (ONDCP).

NASPER updated

Last year, Congress appropriated $2 million to fund the NASPER grants in 13 states. Another federal effort under the Department of Justice has provided an additional $7 million this year to help with the state PDMPs.

Interoperability needed

In testimony to the subcommittee in July, R. Gil Kerlikowske, director of the ONDCP, said that the proposed new version of the legislation would compel interoperability between the state programs. He stated, "Criminal activity does not respect state borders.... Currently, information sharing is done on an ad hoc basis between states."

Rep. Frank Pallone (D–N.J.), chairman of the subcommittee, said that the bill will require states that participate in the NASPER program to specify a timeline for achieving interoperability of their programs with bordering states.

He said the push for interoperability among states began in part when Kentucky found that people were going to other states to circumvent that state's tracking system. In fact, ONDCP units had arrested a number of individuals traveling through Kentucky, Tennessee, and West Virginia on their way to south Florida to obtain medications such as OxyContin, he said.

Shared technology resources

Kerlikowske also told the committee that the Department of Justice, including the Drug Enforcement Administration (DEA), has invested resources in technology to allow states to share PDMP data. A data hub, established at the Ohio Board of Pharmacy, enables Ohio and Kentucky to share test data; these states may begin exchanging real data by the end of the year.

Other states should be able to implement the technology and share data later, he said. He did indicate that much of the work for the PDMPs is done by state entities, including medical boards and pharmacy boards, and said that ONDCP does not recommend that states have identical programs. However, he said, the information states would be required to exchange "would be the things that would be most useful according to the practitioners" in identifying problems.

Asked about the requirement that pharmacies report each dispensed controlled substance within a week, Kerlikowske said that real-time online information would be most useful.

Support to date

The bill, along with legislation supporting safe drug-disposal programs, apparently has received some vigorous support in light of the ongoing revelations about prescription drug abuse, particularly with opioids.

Rep. Kathy Castor (D–Fla.) noted reports of many out-of-state license plates on cars in the parking lots of Florida pain clinics that were raided.

Kerlikowske, who was chief of police in Seattle, Wash. before becoming director of ONDCP, said that he had not known that "more people are dying of drug overdoses than from gunshot wounds, and that was being driven by prescription drugs."

Joseph T. Rannazzisi, deputy assistant administrator, Office of Diversion Control, DEA, told a Congressional hearing in June that there has been a problem in getting healthcare professionals to use the databases when they prescribe controlled substances. The new legislation would require states to promote provider use of PDMPs and education on the system's benefits.

Information from the July 22 hearing is posted at energycommerce.house.gov/. The National Alliance of Model State Drug Laws has information on the status of PDMPs at http://www.namsdl.org/.

KATHRYN FOXHALL is a healthcare journalist based in the Washington, D.C. area.