As Pa. plans closer scrutiny of prescribing painkillers, help sought for addicted patients

Pennsylvania is planning a prescription drug-monitoring program that allows doctors to check a patient’s history with other health care providers before handing over a prescription for certain powerful painkillers.

But Gary Tennis, state secretary of  drug and alcohol programs, said he wants to prevent an unintended consequence as the state works to stop addicts from “doctor shopping.”

“What has happened in other states is that the doctor just says, ‘I know what you are up to, get out of my office,’ and they kinda throw them to the street,” Tennis said.

Desperate opioid abusers then might seek out illegal painkillers.

“They end up going to heroin, which we all know is much cheaper,” Tennis said.

To avoid that sometimes deadly switch, Pennsylvania will teach doctors and nurses patients to identify patients who need help.

“We call it a ‘warm handoff,’ which is having an in-office intervention and referral to treatment,” Tennis said. “Instead of going to heroin they go to recovery.”

Tennis’  office and the state Department of Health will work with the Pennsylvania Medical Society to establish voluntary, free online continuing education training. He said the cost to the commonwealth will be “minimal.”

Even more ideal, Tennis said, would be a group of health care providers who could share the time and skills of a floating recovery specialist who would shuttle between offices when a care provider suspects someone is drug seeking.

About a dozen states now require doctors to check a state database before prescribing controlled medications. This year, New Jersey tightened the rules for its voluntary drug-monitoring program.

But New Jersey’s Drug Policy Alliance opposed the new rules.

“As far as we know, about 90 percent of the people who are prescribed opioid drugs are prescribed them for legitimate reasons, so we are talking about inconveniencing 90 percent of patients and doctors because of patients and doctors who may be seeing opioids for illicit reasons,” said Roseanne Scotti, state director of the alliance.

She said she has doubts about Pennsylvania’s continuing education plan.

“Doctor’s offices are already overburdened with regulation, and get to spend about 15 minutes per patient,” Scotti said. “How they are going to basically do an intervention or try to do an intervention in those circumstances? Seems like it would be very challenging.”

Gov. Tom Wolf has earmarked money for Pennsylvania’s drug-monitoring program, but it may be a year or more before the system is up and running.