Tracking Opioid Prescriptions To Combat A Crisis

Jan 30, 2018

Steve Pollard lives in Jackson Springs. It's in rural North Carolina near Pinehurst. About five years ago, Pollard hurt his back while on the job for a NASCAR team.

"Right after the injury, I couldn't move. Every time I tried to move, it felt like someone was stabbing a knife into both sides of my back," he said. "I went home that night and I ended up in the emergency room because I was in so much pain."

Ultimately, he had surgery, but was let go from his job. Now, he works in IT for the world-famous Pinehurst Country Club. But, pain medication is still a big part of his life.

Steve Pollard, at his home in Jackson Springs, N.C. About five years ago, Pollard hurt his back while on the job for a NASCAR team. Since then, pain medications have been a part of his daily life.
Credit Ben McKeown / For WUNC

Pollard says he takes his medication as prescribed, and even tries to take less when he can. At times, he said he has shown his physician bottles that still have pills in them, even after the prescription should have run out.

But, he says that now when he goes to see pain specialists, they make him feel like a criminal. Like all he wants are more pills to abuse.

"They treat you like you're a lesser class citizen," said Pollard, while sitting on his front porch on a recent evening after work. "Everybody that walks through the door is not there for pain management. They are there to seek narcotics. That's the way they feel. That's the way they treat you."

A Database To Track Prescription Painkillers

Physicians who prescribe painkillers must now enter information on those prescriptions into a database called the N.C. Controlled Substances Reporting System. This tracking system was strengthened last year through the STOP Act, which also put limits on the length of an initial opioid prescription.

Experts say the provisions in the act have generally helped in the fight against the opioid crisis by reducing and more closely tracking prescriptions. But it has impacted some who take their medication responsibly, like Pollard.

From 1999 to 2017 more than 12,000 North Carolinians died from opioid-related overdoses. The N.C. Department of Health and Human Services reports that the epidemic is devastating families and communities. To be sure, public awareness about the opioid crisis has improved. More is understood about the role that prescribers and drug companies played in bringing the nation into crisis.

[The database] kind of allows us to see from a broader sense in a database format, that information. -Dr. Kimberly Sanders

The STOP Act stands for The Strengthen Opioid Misuse Prevention Act. The goal is to decrease opioid misuse. The law targets end users, but also targets doctors and pharmacies.

Dr. Kimberly Sanders is a clinical assistant professor at the UNC-Chapel Hill Eshelman School of Pharmacy. She says the STOP Act improved the use of a tracking system used to see who writes and who fills prescriptions.

"It allows us to track and see 'Okay, wait a minute, there might be four prescribers dispensing for a patient, and we don't necessarily know if they've all communicated with each other about what they're prescribing'," she said. "So it kind of allows us to see from a broader sense in a database format, that information."

The tracking system isn't new, but the STOP Act improved its functionality. The database's detailed info isn't available to the public but licensure boards can mine the data.

"Especially if they've had some red flags or require disciplinary action against some prescribers, they can use the system to double check certain prescribers or see if there are certain providers who are over prescribing certain opioid like substances," said Sanders. "Or at least check the validity of their prescribing."

The STOP Act has other provisions, as well. For example, it allows for community distribution of naloxone, a drug that can reverse the effects of an opioid-related overdose. The act adds specific guidelines for the proper disposal of opioids for hospice and palliative care providers.

Reversing the opioid crisis will take more than one legislative act, of course. It will take combined efforts from families, communities and health care providers. It will take a deeper understanding of mental and behavioral health. But when implemented properly, the provisions in the STOP Act can provide valuable checks in that process.