Bill would require screening on prescription pain relievers

Few doctors use online database

Despite a surge in deadly addictions to prescription painkillers in Massachusetts, few physicians have tapped into an online prescription database created in 2010 to prevent “doctor shopping’’ by patients searching for the powerful drugs.

The Senate is scheduled to vote on a bill tomorrow that would require doctors, in most cases, to first check the database before prescribing the pain relievers, including oxycodone and morphine.

Massachusetts has one of the highest rates of opioid abuse in the country, according to national statistics, and state regulators are concerned that misuse of prescription drugs can lead people to heroin and other illicit opiates, which are cheaper and easier to get.

Only about 1,700 of tens of thousands of Massachusetts doctors are registered for the prescription-monitoring program, which existed for years on paper before the online system was created two years ago.

“Maybe they figure that this is just another interference in [their medical] practice,’’ said Dr. Lynda Young, president of the Massachusetts Medical Society. “Either they don’t know about it or they say, ‘This is voluntary, so I chose not to participate.’ ’’

Under the proposal, drafted by the Joint Committee on Mental Health and Substance Abuse, the 30 percent of doctors who write a majority of the prescriptions for narcotics would be required to register for access to the database by Jan. 1. The remainder would be enrolled as their licenses for prescribing controlled substances come up for renewal.

The bill will not solve the problem of prescription drug abuse, but it is an important step, Senate President Therese Murray, a Plymouth Democrat, said in a press conference yesterday. “It will save lives.’’

Young, a Worcester pediatrician, said she has not used the monitoring database. She said the medical society acknowledges that prescription drug abuse is a problem in Massachusetts. However, she would like to see the state narrow its scope, perhaps by tracking a single drug to start, to make sure the program works smoothly, particularly for those specialists who treat pain.

“We want it to be efficient and effective, and mostly we don’t want it to interfere with clinical care,’’ she said.

Implementation of the bill is expected to cost between $2 million and $4 million, mostly related to the expansion of the database. But lawmakers emphasized yesterday that the practice of doctor shopping and hospitalizations from overdoses carry costs as well.

The rate of hospitalizations for opiates other than heroin, among every 100,000 people in the state, jumped from 14 in 1998 to 103 in 2008, according to the US Center for Behavioral Health Statistics and Quality.

Norfolk District Attorney Michael W. Morrissey said he has seen a spike in deaths from prescription drug overdoses in recent years. “I know we’re not alone,’’ he said. “It’s morphine. It’s all the opiates. It’s unbelievable what’s out there.’’

Joanne Peterson, founder of Learn to Cope, said demand is high for her organization, a support group for family members dealing with addiction that holds meetings around the state.

Many of those affected by prescription drug addiction are honor students and star athletes, and many have died, she said during the press conference.

The bill would require doctors to notify a parent or guardian when a child is treated for an overdose, and it would convene a panel to create clinical guidelines for prescribing drugs for acute and chronic pain. It also would prevent a person from being charged with drug possession while seeking care for themselves or another person experiencing an overdose.

Todd Brown - executive director of the Massachusetts Independent Pharmacists Association, which represents about 120 pharmacies - said he supports the overall aim of the bill, but is concerned with a provision that would require pharmacists to distribute a state-produced pamphlet with information about preventing overdoses, the availability of treatment programs, and the number for a state helpline.

The best place to convey that information is in the doctor’s office, he said.

“Our concern is that this is just going to be another pamphlet that’s not going to do anything,’’ Brown said.

Senator John F. Keenan, a Quincy Democrat who sponsored the bill, said the “short but stark’’ pamphlet is crucial to educating the public about the effects of the drugs and addiction.

“Family members, parents, they’re just unaware how dangerous these drugs are,’’ Keenan said. They think, “they’re approved by the [Food and Drug Administration]. They’re prescribed by doctors; how dangerous can they be?’’