"Doctor shopping" for illicit prescription drugs by Virginia residents showed a 73 percent decline from 2012 to 2013, according to data released this week by the Virginia Prescription Monitoring Program.
The online program allows registered users — physicians, pharmacists and law enforcement — to track the prescription and dispensing of controlled substances throughout the state. Patterns of potential overuse — like using multiple prescribers and dispensers — can be quickly identified.
The monitoring program "has helped to raise awareness about the problem of pain medication abuse, and to amplify actions aimed at putting an end to illegitimate use of these drugs," said William Hazel, secretary of Health and Human Resources.
"We like it. We use it often, three or four times a day," said Jennifer Foster, pharmacist at Gloucester Pharmacy. "It works."
The monitoring program started in 2003 in reaction to a prescription drug abuse epidemic in southwestern Virginia. Since then, it has grown to include physicians and pharmacists statewide who prescribe and dispense Schedule II, III and IV drugs.
About 60 percent of the state's pharmacists are registered in the program and about 30 percent of physicians, said Ralph Orr, the program director. "We separated out those who wrote 100 prescriptions or more a quarter for controlled substances," he said. "Of those, 87 percent are registered and use the program."
Since October 2009, when the system went 24/7 and provided automated responses to requests — each within about a minute — its use has multiplied, with about one-third of requests being made by emergency care providers in evenings and on weekends, according to a 2010 report to the legislature. In 2012, 90 percent of requests were made by physicians; this dropped to 68 percent in 2013 after a surge in pharmacist memberships, according to the most recent data.
"We just wish it were real-time," said Foster, who anticipates that as a possibility. Currently, dispensers report to the system every two weeks.
Gov. Terry McAuliffe signed a bill this year requiring all prescribers to register with the monitoring program by July 2015. Pharmacists and physicians will be automatically registered when they renew or apply for a license.
The Virginia program is connected to monitoring programs in 15 other states, extending further controls against doctor shopping and using multiple pharmacies. North Carolina, the only neighboring state that is not yet connected, is in the process of joining the network. Federal facilities, such as the Veteran's Administration and Department of Defense pharmacies do not report to state monitoring programs.
Orr noted four trends in the most recent data:
• An increase in the number of requests — checks on potential misuse by patients — made by pharmacists and physicians, from 860,000 in 2012 to 1.3 million in 2013.
• A decrease in the overall number of prescriptions dispensed, 3.4 million to 3.1 million.
• A decrease in the number of doses of pain relievers, but an increase in doses of stimulants, such as Ritalin and Adderall, used for attention deficit disorder.
• A decrease in the number of patients identified as "doctor shopping," those using at least 10 prescribers and 10 dispensers, from 297 in 2011 to 81 in 2013.