By Steve Ariens Phar.D.
You know from my perspective, “the system” is designed to fail and has been since it was established in 1973 when the DEA was spun off the Controlled Substance Act.
Attorney General Sessions just announced that the DEA is going to do data mining in every health database that they can get into and they are going to use “average stats” of how many prescriptions or doses that a doctor writes and/or a pharmacy dispenses. You can’t determine medical necessity via statistics.
I posted over the weekend that a doc whose sole practice was hospice and palliative care was busted because the number of opiates he wrote was outside of the norm.
In a recent article, AG Sessions stated that prescribed opiates are at an 18-year low, but he is going to reduce them by another 33% over the next three years. In 18 years our population has increased some 20%-30% so if you look at prescriptions per millions of people, the reduction is more drastic.
IMO, that new NarxCare is going to fail because we don’t have confirmed identifications on patients. They are supposedly going into all sorts of records from criminals, PMP, EMR, Medicare/Medicaid Rx claims—and what happens with people with similar names or other criteria or someone uses stolen name and the real person ends up with a score going to indicate they are at risk of being a substance abuser?
I am not aware of any healthcare professional that has access to the BMV’s on line data base to validate a patient’s ID. There is a E-verify for Social Security Numbers but only employers can use it before they hire someone.
We have digital finger print readers!
We have facial recognition!
We have optical scanners!
And healthcare uses none – no PMP uses one
There is a short-written test SOAPP-R https://d1li5256ypm7oi.cloudfront.net/colospine/2016/08/SOAPP-R-Screener-and-Opioid-Assessment-for-Patients-with-Pain-Revised-160816-57b258fc9a277.pdf that can score the risk of a patient’s risk of being a substance abuser… but few/no healthcare providers use it.
We just renewed our driver’s license in Florida to get the new TSA approved driver’s license.. we have had a driver licenses in FL since 2005 but this time to renew we had to produce a PASSPORT, two utility bills, tax records with addresses that matched our driver’s license. (Talk about voter suppression, but that’s an article for a different blog)
But just about anyone can seemingly walk in and try to get a controlled med with fake ID’s and if the prescriber accepts the information – even if fake – and it cascades thru the medical record system. Pharmacy takes it at face value and puts in the state’s PMP records… files insurance claims… It is the first domino that falls and cause others to fall.
Would chronic pain patients be willing to go thru a lengthy ID verification process and have a RFID chip implanted to keep from being denied pain management and get certified ID that all healthcare professionals would willingly accept?
Whatever is done, the DEA has to sign on… in case you haven’t noticed there has been a lot of other entities trying to implement different things and the DEA is not part of the discussion and the DEA doesn’t change one thing that they are doing… so everything else being done is “window dressing” so that chronic painers believe things will get better in the end… nothing has changed.
Steve Ariens is a retired pharmacist who is a chronic pain advocate. He is a frequent contributor to the National Pain Report.