Physicians, pharmacists now tracking opioid pain pill prescriptions in Pa.

The monitoring program is designed to limit patient access to controlled substances such as opioid pain pills that are likely to be abused or to make users dependent on them.

Starting last week, physicians can check the monitoring program every time they prescribe a controlled substance to a patient for the first time to make sure that the patient isn’t already receiving pills from another doctor in the state.

Pharmacists have to submit to the monitoring program every time they fill a prescription for a controlled substance.

While the program is geared to reduce patient doctor shopping or pill shopping, it also will force physicians and pharmacists to have difficult conversations with patients they suspect are addicted.

“We already have these difficult conversations, but the monitoring program will cause us to have a few more of them,” Dr. Dan Bledsoe, medical director of Harrisburg-based PinnacleHealth Westshore Hospital’s emergency department.

Critical conversations

The monitoring program gives physicians some ground to stand on when approaching patients, because now they have data to back up what they’re saying.

“Some people will probably leave angry when confronted, but some will own up and recognize they need help,” Bledsoe said.

Physicians have concerns about patients reacting negatively, but they are prepared to justify the monitoring system by explaining to patients the importance of protecting them from the dangers of prescription pain medications.

In Pennsylvania, more people are dying from drug overdoses than car accidents, so conversations about the risks of misusing medicine are critical.

“We can’t have 10 people a day die of overdoses – that’s not acceptable anymore,” said Dr. Chris Echterling, medical director of vulnerable populations at York-based WellSpan Health System.

Keeping people off the street

The Pennsylvania Department of Health, which is overseeing the monitoring program, is also providing physicians with resources so that when a patient accepts help, physicians know what to do.

In the health care world, this is typically referred to as a “warm hand-off.”

In Dauphin County, for example, if a patient arrives at the emergency room or a doctor’s office and is visibly addicted to opioid pain pills – say, he or she is overdosing – the county’s drug and alcohol agencies will send someone to the health care facility to meet the patient face to face and assist the person in getting to treatment or detox, Bledsoe said.

The reason for having a warm hand-off plan in place is to prevent patients from going out and finding similar opioids, such as heroin, on the street.

“There will be people that are pushed onto the streets, but the state is doing a good job of providing resources to keep people from that,” Bledsoe said.

The key is that the patient has to want help. When patients reject treatment, it creates “a lot of emotional drain on the staff,” Echterling said, adding that addiction is a deadly, chronic disease.

A study found that more than 259 million opioid prescriptions were written across the U.S. in 2012, and an estimated 1.9 million Americans are addicted to opioid pain pills.

Now with the monitoring program live and new prescription guidelines released by state regulators last month, the health care industry in Pennsylvania should start to have more control over a spiraling epidemic.

“We realize we really don’t know who’s gotten into trouble,” Echterling said.