Maryland's Prescription Drug Monitoring Program (PDMP)
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A Comprehensive Strategy
In 2011, the White House Office of National Drug Control Policy released Epidemic: Responding to America’s Prescription Drug Abuse Crisis, a national strategy designed to address the problem in a comprehensive and inter-disciplinary fashion. The strategy contains four core components:
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Education of parents, youth, patients, and healthcare providers. Although many drugs with serious abuse potential are widely prescribed and can be found in the medicine cabinets of millions of Americans, many parents, their children and patients who have been legitimately prescribed controlled substances may not understand the dangers posed by their use outside the direction and guidance of a licensed, competent medical professional. Similarly, healthcare practitioners must have access to the most current applicable laws, regulations, clinical guidelines, research and best practices relating to the risks and benefits of using controlled substances in the treatment of various conditions. The information providers need includes techniques for mitigating risks and maximizing benefits and knowledge of how to effectively identify and assess substance abuse and other co-occurring mental health disorders in their patients and, if necessary, facilitate access to treatment. These initiatives will require collaboration with lawmakers, government agencies at the federal and state level, drug manufacturers, private and public insurers/payers, professional societies, medical schools, local businesses, and non-profit advocacy organizations.
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Tracking and monitoring of the prescribing and dispensing of controlled substance and trends in prescription drug abuse and diversion. To this end, PDMPs should be established in every state, integrated with statewide Health Information Exchanges and other states' PDMPs, and improved to promote greater access to and use by providers and other stakeholders authorized to request prescription data. PDMPs can serve as the platform for staging collaborative statewide initiatives that connect and coordinate each component of the overall strategy.
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Proper disposal of unused or expired prescription drugs that could make their way to non-medical use. This includes administrative reforms to establish permanent locations for safe drop off and disposal and the staging of local drug "take back" events in the meantime.
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Enforcement of laws and regulations created to ensure the proper use of controlled substances and protect the public. Criminal organizations that often exploit the elderly or seriously ill individuals to illegally amass prescription drugs through "doctor shopping", prescription theft and forgery or other diversion schemes should be identified and dismantled. Likewise, though the vast majority of healthcare practitioners work diligently to provide patients with the best possible care, the small number that abuse their privileges and the trust of the community by prescribing or dispensing controlled substances for illegitimate or illegal purposes can have a disproportionate negative impact on prescription drug abuse problems. Through judicious use of criminal, civil and regulatory/licensing enforcement procedures, the black market supply of prescription drugs coming from unscrupulous providers can be significantly reduced.
