A Comparison of the Prescription Drug Monitoring Programs (PDMPs) for Three States with a High Public Health Burden of Prescription Drug Abuse: West Virginia, Ohio and Kentucky

By White, Tamela J.; Thomas-Bush, Samantha | Defense Counsel Journal, January 2016 | Go to article overview

A Comparison of the Prescription Drug Monitoring Programs (PDMPs) for Three States with a High Public Health Burden of Prescription Drug Abuse: West Virginia, Ohio and Kentucky


White, Tamela J., Thomas-Bush, Samantha, Defense Counsel Journal


THE United States' Centers for Disease Control and Prevention estimates that there are 44 deaths each day from prescription pain medications which is a staggering number exceeding 16,000 persons a year. (1) President Barack Obama's trip this week to West Virginia is described by Time Magazine as a "Visit to Center of Heroin Epidemic." (2) Ohio has seen a major increase in opiate-related overdose deaths. Preliminary data by the Ohio Department of Health comparing deaths from fentanyl alone reported a 402% increase in the year 2014 over the year 2013 alone. (3) The Kentucky Commonwealth reports that over the past decade, the number of Kentuckians who die from drug overdose is now more than 1,000 a year. (4) One time tested public health tool used for identification of vulnerabilities and source exposures has been state-based databases such as vaccination and contagious disease monitoring programs. Prescription drug monitoring programs (PDMPs) are an invaluable means for public health and law enforcement officials to collect and analyze data and identify offenders and high-risk populations. These databases provide real-time, point of access prescription medicine monitoring. This note provides an overview of the PDMPs in the states of West Virginia, (5) Ohio, (6) and Kentucky. (7)

I. Professions Regulated

Prescribers and dispensers are subject to these acts. Each is required to review report regulated substance prescribed and dispensed depending on the type of substance and state. Prescribers include those with prescriptive authority for Scheduled Drugs commonly referred to as CI's through CV's, following the federal Closed System of Control Substances Monitoring. (8) Each state's law differs as to those categories of professionals with controlled substances prescriptive authority. For instance, advanced nurse practitioners and physician assistants may be permitted to only prescribe CIII-CV drugs or CIIs in limited quantities. Whenever the registered preserver makes a prescription, his/her unique DEA identifier populates a field within the PDMP database and data tracking begins based upon that personal identifier. Dispensers include pharmacies and pharmacists who likewise are obligated to register in accordance with the law of each state and to have operable computer data base systems for immediate data retrieval. The same as with prescribers, data entry for purposes of filling a prescription and dispensing it to a purchaser results in immediate source tracking data generation. Purchasers may not be end users, and regulations have been adopted by state board of pharmacy requiring photo identification data collection of purchasers, which results in another means to monitor and follow distribution.

II. Professional Compliance Obligations

Information sufficient to reasonably identify the intended end-user (patient), prescriber, dispenser, type of controlled substance and quantity dispensed must be reported within each state's PDMP. Prescribers and dispensers are afforded access to the PDMP and are obligated to conduct reasonable search inquiries before actual prescribing or dispensing.

Of the three states that are discussed herein, the Commonwealth of Kentucky has the most stringent requirements for prescribers with respect to reviewing the data available through the PDMP. In Kentucky, a prescriber has the duty to review a patient's "Kentucky All-Schedule Prescription Electronic Reporting System" (KASPER) report before prescribing any CII, CIII and some CIV drugs." (9) Kentucky prescribers are also obligated to query KASPER at least every three (3) months for each patient who previously was prescribed one of the identified categories of controlled drugs and needs a new prescription or a refill. (10)

West Virginia imposes different obligations. Its program is the "Controlled Substance Automated Prescription Program" (CSAPP). Pharmacists and those with dispensing licenses are obligated to provide information to CSAPP on a rolling 24-hour basis. …

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