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Editorial: Doctors Need To Support Bill On Drug Database

VENTURA COUNTY STAR
http://www.vcstar.com/opinion/editorials/editorial-doctors-need-to-support-bill-on-drug-database-36fb8dde-7ff2-5dd6-e053-0100007fe35b-385761441.html

The numbers are staggering and getting worse. More than 165,000 Americans died from prescription opioid overdoses between 1999 and 2014, according to the U.S. Centers for Disease Control and Prevention. The state Department of Public Health says 1,895 Californians died of opioid overdoses in 2013. An additional 11,683 — an average of 32 a day — were treated in California emergency rooms for nonfatal overdoses and other opioid-related conditions.

This March, the CDC issued new painkiller prescription guidelines, calling them "part of the urgent response to the epidemic of overdose deaths." A month later, musician Prince accidentally overdosed on the painkiller fentanyl.

One key CDC recommendation was that doctors always check a patient's prescription drug history on state databases before prescribing opioids to him or her. "The prescription overdose epidemic is doctor-driven. ... It can be reversed in part by doctors' actions," CDC Director Dr. Tom Frieden said.

The idea behind such databases is to help doctors avoid prescribing lethal combinations of drugs, and to prevent "doctor shopping," where addicts seeks multiple prescriptions from different doctors.

You would think doctors would be all for this. The database has been proven to work. But some doctors are still not checking it, for whatever reason, so state Sen. Ricardo Lara, D-Bell Gardens, introduced a bill last year to require them to use it.

The bill has a long list of supporters — the California Narcotics Officers' Association, American Insurance Association, California Chamber of Commerce, Teamsters, National Alliance on Mental Illness, Consumer Watchdog — and only one registered opponent.

You might have guessed who: the California Medical Association.

SB 482 has passed the state Senate and is expected to go to the full Assembly in late August. We think it's time for the California Medical Association to stop throwing up obstacles and get behind this bill.

The bill would require doctors and other providers to check a patient's prescription history on the state's Controlled Substance Utilization Review and Evaluation System, or CURES, before prescribing potentially addictive drugs. It would cover a wide range of prescriptions, including fentanyl, OxyContin, Xanax, Valium, steroids and sleep aides. Doctors also would have to check the database every four months if the drug regimen is continued.

More than 20 states have such a law. After New York adopted one, doctor shopping dropped by 75 percent, the CDC reported.

The California Medical Association claims the bill amounts to legislating medicine and says it also is concerned about patient privacy, some confusing language and whether the database can handle the 200,000 or so California doctors, pharmacists, nurse practitioners, physician assistants and others licensed to prescribe or dispense controlled substances.

We think that's mostly a smoke screen. Capitol Watchdog, an arm of Consumer Watchdog, points out that the California Medical Association has fought the idea since 2013, when it was stripped from previous legislation. When 2014's Proposition 46 called for required use of the database, doctors ran TV ads with false threats about hackers stealing patient information, Capitol Watchdog says.

The California Attorney General's Office announced this year that a two-year, $3.6 million upgrade of the CURES database was complete. Any health care provider licensed to prescribe or dispense medications had to register for the database by July 1.

Supporters of SB 482 concede it won't end the scourge of opioid abuse but say it's part of the solution. We urge all health care providers to get on board, support the bill and take full advantage of a database that can save lives.