Editorials

EDITORIAL

‘Doctor shopping’ is going to get more difficult

This undated photo provided by the Tennessee Bureau of Investigation shows fake Percocet pills that are actually fentanyl that were seized and submitted to bureau crime labs. Narcotics officers across the country are altering the way they do business due to concerns about fentanyl, a drug blamed in thousands of overdose deaths in recent years. Even minute amounts of fentanyl can be deadly, and police are being warned to avoid inhaling power or even touching the drug since it can be absorbed into the skin. (Tommy Farmer/Tennessee Bureau of Investigation via AP)
AP PHOTO

It may have taken a frightening surge in opioid abuse to speed action, but Massachusetts now has a user-friendly online system for keeping track of drug prescriptions. The state monitoring program went live last week, after a $6.2 million overhaul of an unwieldy system that many doctors avoided like a virus. The new one is simple and fast. It pulls in real-time data from prescriptions written for controlled substances, including widely used opiates like oxycodone and hydrocodone. Doctors, nurse practitioners, and other prescribers have to consult the database before writing such a prescription for any new patient, as well as when they give existing patients their first prescription for a controlled substance. Starting Oct. 15, they’ll be required by law to log on before scribbling their signature on any narcotics prescription.

Right off, the system should discourage “doctor shopping” — that’s when someone makes the rounds of physicians’ offices and emergency rooms, feigning pain to collect a stash of pills. The revamped database also might help doctors identify patients with chronic conditions who are unwittingly falling into a pattern of abuse or outright addiction. Conversely, it should give doctors the confidence to prescribe an opiate for a patient who has no record of abuse and is in need of pain relief. “This can only improve the qualify of life and safety for patients,” said James S. Gessner, president of the Massachusetts Medical Society. He’s right — there’s no obvious downside.

Still, the initial response to the monitoring system was sluggish — the medical mainstream doesn’t easily change course. By the end of last week, though, acceptance was spreading. About 80 percent of Massachusetts’ 46,634 prescribers had signed up, according to the Department of Public Health, and 71 percent of the 25,457 doctors and other health professionals who prescribed an opioid during the last six months were on board. More important, plenty of them are using the system. The number of searches has topped 10,000 every day since the Aug. 22 launch, said DPH spokesman Scott Zoback, and the average response time has been a zippy 1.5 seconds. Of course, it’s too soon to know how many of those inquiries changed a doctor’s mind about how to treat a patient.

Advertisement

The database is just one tool in the effort to curb the scourge of opioids, and the technology is going up against a formidable force — human ingenuity. Some people desperate to get their hands on a vial of Percocet won’t limit their hunt to within Massachusetts borders. State officials say the monitoring system’s data will be shared with similar programs in Connecticut, Rhode Island, and Vermont. New York is expected to be online by the end of this month, and there are plans for data sharing with Maine and New Hampshire. That’s encouraging, but even greater coordination is needed to put a real squeeze on cross-border pill peddling. Congress should act swiftly to establish and fund a national database modeled after Massachusetts’ streamlined system. This is one of those matters that really does involve life and death.