nj.com: Doctors need help stopping those buying prescription drugs illegally | Opinion

8/16/2017

By Peter Carrazzone   

New Jersey physicians are using the New Jersey Prescription Monitoring Program database as an everyday part of their practice. There is no disputing that it is an extremely useful tool, but there are glaring limitations when put into real practice in a physician's office.

The New Jersey Board of Medical Examiners has stated that among nonmedical users, 76 percent take medication prescribed for someone else through diversion/sale, while only 20 percent indicate they personally received the medication through a legitimate prescription.

Individuals obtaining controlled-substance pain medications by misrepresentation, fraud, forgery, deception or subterfuge is a crime in New Jersey, as outlined in state statutes (N.J.S.A 2C:35-13 and N.J.S.A. 2C:35-10.5). The Prescription Monitoring Program, or PMP, provides the state with a map to track these individuals who are breaking the law.

But there are still individuals who spend their days filling prescriptions, traveling to multiple practices and pharmacies across the state, with variations of their name, date of birth and address to elude the PMP system -- sometimes paying cash and other times utilizing insurance -- with the ultimate purposes of diversion and sale.

Sorting through multiple variations of a name and PMP entries to piecemeal criminal activity by a physician takes time and is simply not realistic at every practice, so the next practice may unknowingly be duped without being complicit or a "bad doctor."

The responsibility for ending the opioid epidemic has been placed at the feet of physicians and pharmacists. However, when an individual presents to a physician in search of a controlled substance and criminal activity becomes apparent, prescribers have limited options -- one of which is to simply not write the prescription and send the patient on his or her way, with the knowledge that the individual will likely just move on to the next practice to try the scheme again. That simply isn't good enough.

Physicians can provide counseling and offer education to patients on treatment options when there is evidence of addiction or dependence; but what can physicians do when they come across someone likely involved in diversion? What options do they have beyond watching the individual walk out their door?

Too often, when these individuals visit physicians' offices or urgent care centers, our physicians have called local law enforcement and the PMP for guidance, with little success. Last week, the state rolled out a Suspicious Activity Report, where suspected fraudulent activity can be reported.

However, more must be done. Without a state PMP hotline for prescribers to call and quickly report this type of suspicious behavior, physicians can only hope the system catches up with these criminals.

Yes, there are bad actors in every profession -- but the overwhelming majority of physicians in New Jersey are ethical and dedicated advocates for their patients.

We need to stop criminalizing physicians complying with opioid-prescribing guidelines from the U.S. Centers for Disease and Control and Prevention and the state's prescribing laws. Rather, let's encourage the state attorney general to use the tools available within the PMP to focus on the blatant criminal activity right under the state's nose and provide a hotline for prescribers and pharmacists when they suspect criminal activity.

Those who are intentionally and illegally misrepresenting themselves to obtain controlled substances should be the focus as contributors to the opioid epidemic and must be held accountable.

Dr. Peter Carrazzone is president of the New Jersey Academy of Family Physicians.