Implementation of a Prescription Drug Monitoring Program for North Dakota

In Fiscal Year 2006, Congress appropriated $7,500,000 to the U.S. Department of Justice to support the Harold Rogers Prescription Drug Monitoring Program. Prescription monitoring programs are systems where controlled substance dispensing data is submitted to a centralized database administered by an authorized state agency. These programs are designed to help prevent and detect the diversion and abuse of pharmaceutical controlled substances, particularly at the retail level where no other automated information collection system exists.

States that have implemented prescription drug monitoring programs have the capability of collecting and analyzing prescription data much more efficiently than states without such programs, where the collection of prescription information requires the manual review of pharmacy files which is a very time consuming and invasive process. The increased efficiency of prescription monitoring programs allows for the early detection of abuse trends and possible sources of diversion. The analysis of collected data also allows for the identification of outmoded prescribing practices, such as the undertreatment of pain, which may result in the development of educational programs for medical professionals.

The North Dakota Prescription Drug Monitoring Program (NDPDMP) will utilize an electronic monitoring system to facilitate the transmission and collection of data regarding all controlled substances dispensed to patients in North Dakota and to analyze data and report on the prescribing, dispensing, and use of controlled substances. This program will allow faster identification of individuals involved in diversion. One recent case in ND involved a patient fraudulently utilizing 43 pharmacies and 50 physicians during a 12-month period. With the NDPDMP, offenders will be identified much sooner than is currently possible.

In addition to law enforcement and investigative activities aimed at preventing illegal diversion, a second major issue will be addressed through implementation of the NDPDMP. As a benefit to improving patient care, the information collected and analyzed pursuant to the NDPDMP will be utilized to ensure that prescribers and other healthcare professionals have access to accurate, timely prescription history information to use when initiating appropriate medical treatment and interventions, or to assist in identifying patients at risk for addiction or who may benefit from referral to a pain-management specialist or to substance abuse treatment. The data will also be vital to assist pharmacists in the provision of pharmaceutical care. Achieving the balanced goals of providing adequate pain management, and preventing diversion and abuse of prescription controlled substances requires exchange of information and perspectives, identification of issues, and concerted action between regulatory and medical interests. In addition, the implementation process, along with the development of administrative rules, will require the flexibility to address issues of vital importance to the healthcare community, such as confidentiality of professional-patient relationships, and the limitation of liability for the disclosure of information.

CA/NCF