February 2, 2015

Compromise Bill Requires Prescription Checks

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TX - Addicted Oklahoma bug closer

The compromise bill currently being negotiated with physician groups would require doctors to check the database the first time they write a new prescription for three classes of addictive drugs and at least once every 180 days after that.

In a concession to physicians, the legislation would exempt drugs prescribed at nursing homes. It also contains a five-year “sunset” provision that would allow the law to expire unless the Legislature voted to reauthorize it.

Last year, the governor and her legislative allies fell a few votes short of advancing a bill that would have required doctors to check the database every time they wrote or refilled a script for a much longer list of drugs. Groups representing medical doctors and osteopaths actively opposed it.

“I’m hoping this will be an example of how Oklahoma is different than Washington, D.C., and that we can all live with a compromise that no one likes just because it’s not the perfect bill,” said Rep. Doug Cox, the measure’s House author and key negotiator.

“We have to do something,” said Sen. A.J. Griffin, who is sponsoring the legislation in the Senate. “With our failure to act last session and the fact that we continue to have arrests and continue to see overdose deaths … it’s one of our most important issues. We can’t continue to just allow this to go on.”

The prescription check legislation is intended to address an overdose problem that some health experts say has reached epidemic proportions in Oklahoma.

Last year, more than 800 Oklahomans died from overdoses, many of them after taking medications prescribed by their own doctors. Oklahoma has one of the highest narcotic prescribing rates in the nation.

“We want to be part of the solution,” said Wes Glinsmann, director of state legislative and political affairs for the 4,500-member Oklahoma State Medical Association, which represents M.D.s.

“We’ve been trying to work for legislation that really addresses the problem, without overburdening the physicians and patients on drugs that really aren’t the problem,” Glinsmann said.

Oklahoma, like most states, has an online Prescription Monitoring Program. Pharmacies are required to log every prescription for controlled dangerous substances within five minutes of filing it.

But doctors are not required to check the PMP registry to make sure their patients aren’t obtaining prescriptions from other physicians, and many doctors don’t bother to check.

Last year, Cox, Griffin and the governor’s office failed to win approval of legislation that would have required doctors to check the PMP every time they wrote or refilled a prescription for Schedule II or Schedule III controlled substances. That included all of the addictive opiate painkillers such as oxycodone and hydrocodone as well as many non-narcotics such as testosterone and other hormone supplements.

The Oklahoma State Medical Association and the Oklahoma Osteopathic Association lobbied against the measure. They said the mandatory checks would place an unnecessary burden on overworked physicians and their staff members.

This year’s legislation is a scaled-down version of last year’s. It would require PMP checks for only three types of drugs: opiate painkillers such as OxyContin and hydrocodone, benzodiazepine anti-anxiety medications such as Xanax and Valium, and carisoprodol, a frequently abused muscle relaxer marketed as Soma.

Cox said the 180-day recheck provision is a key compromise needed to secure the support of doctors and osteopaths who don’t want to check the database every time they authorize a refill. Most opiate painkillers and other commonly abused substances must be reauthorized every 30 days.

“Doctors are all over the map on that,” said Cox, R-Grove. “I’ve had some doctors who said, ‘I don’t want the government telling me anything.’ I’ve had doctors who said, ‘I can live with every six months.’ I’ve also had doctors say, ‘If the Oklahoma State Medical Association doesn’t go along with checking it every time, I’m not going to renew my membership.’”

Oklahoma Mental Health Commissioner Terri White, who is helping negotiate the PMP bill, said its passage was critical.

“The PMP system is a tremendous tool. But it only works if used, and used every time by prescribers,” White said in an emailed comment. “Full utilization of this system, simply put, will save lives.”
The bill contains exemptions for drugs prescribed at nursing homes and for end-of-life or hospice care. The nursing home provision wasn’t in last year’s bill.

Two other additions to the bill are notable. One would include veterinarians, who sometimes prescribe narcotic drugs for treatment of animals. They would be required to check the PMP to make sure the owners aren’t obtaining unusually large quantities of abused drugs.

Another new provision would require the Oklahoma Bureau of Narcotics and Dangerous Drugs to forward a monthly list of the top 20 prescribers of controlled dangerous substances to the licensing boards governing medical doctors, osteopaths, dentists, optometrists, nurses and podiatrists.

Last year, Oklahoma Watch and The Oklahoman published an investigative report showing, among other things, that enforcement efforts were hindered because state agencies sometimes failed to share information about overdose deaths and overprescribing.

Besides the PMP check legislation, Griffin, R-Guthrie, has introduced a bill that would try to get more doctors to prescribe newer versions of opiate painkillers that are more difficult for abusers to grind into powder form and either inject, smoke or inhale by “snorting.”

The bill also contains provisions authorizing the Oklahoma Health Care Authority to reimburse doctors who use a more expensive urine-testing process to spot abusers among the Medicaid patients they treat.

In her 2015 “State of the State” address Monday, Fallin urged the Legislature to pass the PMP measure this year, noting that Oklahoma ranks at the top of the nation in prescription drug abuse.

“There are things we can do here at the Capitol, starting by passing a prescription drug monitoring bill that cracks down on the practice of “doctor shopping” and ensures we aren’t prescribing narcotics to addicts,” Fallin said.

  • May

    doctor Myers is a drug pill mill pusher he is now trying to get his license in Arkansas .

    • bsme

      This is all misleading typical Republican facism from profressional critical thinkers. What these jerks have done is put the power of control in a dope dealing business that only the big corporation pain managemenet clinics can have.
      Major up front costs without ins. 300.00 plus for intial visit at a clinic i checked into without ins and 200 per visi there after. Urine testing. As far as od’s go; alcohol is a bigger killer but ol Gov Fallin and her crew of crusaders favor the wealthy, therefore giving the pane med sript writing to Pane Management Clinics. In return place all chronic pain patients in a corral and make millions off their control of the people who want and need their pane meds.
      Dr’s alike have had their care taking control taken away in many ways. This redicculous state of OK says they go a step further than Washington to protect the citizens of OK.. What a crock of crap. ER’s can’t write a script of pane meds in OK…..the ER!! Christ its a hospital.
      Folks its all about control of the people and its not just pane meds.
      This entire issue of laws concerning pane management is a lie. Oklahoma is a state that takes things to another level. Stupid levels…..

  • May

    Tougas the back cracker is a molester and doctor Howell is the worse of the worse when it comes to sexually attacking women ,,i will not stop tougas or Howell as for the Ok,medicle baord they to are responsible for what has happened to me by given both doctors their lic,to practice with out checking their back ground,then maybe me and these other women wouldnt have been touched at all,as for debbie cox the Irs has got her number

  • Penny Morris

    It is ok to do the test but if is mandatory by the state then they shoud pay for it. My husband and I have been tested and his was over$250.00 after insurance and mine wa $400.00 after insurance. I am not paying $1300.00 a year for this test, that is crazy.

    • Kate

      I’m having the same problem. I’ve been on Adderall for 8 eight years for my ADHD, and, as a graduate student, I cannot function without it. I have never abused drugs and have always tested clean. So, in addition to the $20 a month I pay for my prescription, I now have to pay $400 (with insurance) every 180 days just to maintain my treatment? We’re talking $800 a year. The test itself costs no more than $55 for the hospitals administering it! I understand certain measures need to be taken to prevent people from abusing prescription drugs, but what I don’t understand is why those of us who need these drugs and use them as prescribed are being punished for it.

    • Judy Smith

      Penny I am disabled and unemployed,receive NO benefits from the government(state or fed). Not only am I forced to pay 60. for a doctors visit for the drug test but am charged 1194. for each test. Did I say I have NO arrest record and NO history of drug abuse and have NEVER failed a drug test. I have between 10-30% heart function and can’t work.There’s no money for insurance and if there were I would never be able to pay the deductible down to be able to use it. At this point I wish I were an immigrant or refugee…they get the “free” stuff.
      I have an elderly aunt that is barely mobile. She cannot get out every month and drive for a drug test yet she can receive NO pain medication because of the new laws.
      Mary Fallen DID NOT take anything into account. I don’t like being treated like an abuser and I hate seeing my aunt suffer. I’m watching for a class action discrimination suit against the state for it.

  • Michele

    All this is doing to shifting a problem into a much MUCH more larger & dangerous problem. And of course these ass hole organizations that don’t know anything except what they choose to comprehend that day are destroying lives. There are thousands of people in Oklahoma that are taking narcotic prescription drugs so they can function & not be a drain on society. A very dear friend of mine was diagnosed with RA at 24, she could walk only with the assistance of a cane at 25. If it weren’t for pain medication, she would be sitting at home collecting disability & living off the system. She’s been functional & able to work (until recently) thanks to pain medication that her doctor recently stopped prescribing her without cause…other than “it’s too time consuming to check patient records”. AKA, “I don’t want to get in trouble for nothing by the DEA.”
    Just like there are thousands of Oklahomans that have allergy problems and need decongestants. These laws mainly hurt the honest people out there that need help. I heard on the news this big victory on the decline on prescription drug “abuse”. What Fox news later revealed was that “decrease” happened in conjunction with a 30% increase in middle aged, middle class women using heroin. Is forcing people to street drugs really a “victory”? Thank you America, thank you Oklahoma….you have now pushed, thrown, forced people who need a physicians help to improve their quality of life….so they don’t become a “drain on society”, to street drugs….from buying narcotics off the street. Great job. Thumbs up. I hope you all give yourself a BIG pat on the back….or as I would prefer, a swift kick to your ass!

    • Jennurse79

      Absolutely agree 100%. Just wait until the heroin hits the state. I just moved back from Pennsylvania and it was a huge huge problem there. My kids couldn’t walk to the corner store without being approached by someone selling.
      I am a fibromyalgia patient, RA sufferer, and have just completed radiation therapy for my cancer – guess what…. My genius physician has refused to give me anything for pain. It’s not ok to punish the one’s who need help!!

  • bye mary fallin 2018

    mary fallin is a self exobing selfish republican who dosnt know how to govern she couldnt even pass the medcaid extention act cus shes only for the rich she got only 3 more years and then we get a real true governor not a slut whore whos for the rich . she only cares about the people that bought her out who put the bitch into office.

  • T

    My husband and I are both taking pain meds. We see the same doctor. I’m on disability and he is insured thru his company EACH month our doctor has us take a urine analysis that cost $500 each plus office visit. However, should one of us need an injection, then the UA cost $45 dollars. So our out of pocket for one month for a UA is $1000. Listen you that want to control , or as you say stop, drug abuse YOU CAN’T. Those that abuse will always abuse and those of us who don’t will ALWAYS PAY the price for you guys to feel good about yourself. How about putting a cap on how much and how often a doc may charge for a UA or an office visit or a damn injection. The rich get richer, greedier and dumber.

  • T

    Please help the law abiding citizens. Stop telling my doc what he can and can’t do. Instead set up a hot line and you will get the abusers without making the rest of us pay the price. Thanks