One phenomenon that we’ve seen come out of the opioid crisis is something called doctor shopping, where people visit multiple physicians (including emergency room doctors) in order to obtain multiple prescriptions for a medication. For example, someone might go to an emergency room complaining of pain – which they may or may not actually be experiencing – and then go to a clinic with the same ailment, and then find their way into a specialist’s office. All the while, they’re receiving prescriptions for the same opioid medication, and they end up with far more than any one person really needs. They can then sell them or use them illicitly themselves. In an effort to limit doctor shopping, California will soon require physicians to check a patient’s prescription drug history before prescribing opioids.
California already has a registry of prescription histories – it has for decades, in fact – for doctors and pharmacists to consult. Unfortunately, it has been rarely used. Beginning on October 2, doctors will be required by law to check the database. The hope is that they will not only see when they should deny a prescription to a patient, but be able to offer information about treatment when they suspect drug abuse. The database, called the Controlled Substance Utilization Review and Evaluation System, or CURES, keeps track of all Schedule II, III and IV controlled substance prescriptions dispensed in California. Clinics, pharmacies, or anyone else who dispenses these medications are required to submit weekly reports.
This new law will hopefully not only prevent doctor shopping but allow physicians to better care for their patients. For example, even if someone isn’t abusing drugs, they might be taking a medication already that will react badly with something the doctor is thinking about prescribing. Anti-seizure medications, certain antibiotics, antidepressants, antifungals, antiretroviral drugs (used to treat HIV), drugs for sleeping problems, drugs used to treat psychiatric disorders, muscle relaxers, and sedatives can all cause adverse effects when taken with opioids. Taking these medications together could lead to a decreased heart rate, slowed breathing, and even death. If a doctor checks the CURES database before prescribing, however, he or she will see a list of everything the patient is currently taking and be able to choose a medication accordingly.
There are some exceptions to this new law. Emergency departments can prescribe a seven day supply, with no refills, without first consulting the registry. After surgery, a five day supply can be given without checking the database. The law also doesn’t apply to people in hospice care.
Some doctors worry that being required to use the database will be more time consuming than it’s worth. They point to the multiple technical problems still plaguing the system, as well as the non-user friendly format that takes valuable time to navigate.
If you or a loved one need help with quitting drugs or alcohol, consider Asana Recovery. We offer medical detox, along with both residential and outpatient programs, and you’ll be supervised by a highly trained staff of medical professionals, counselors, and therapists. Call us any time at (949) 438-4504 to get started.