N.H. Lawmakers Weigh Boosting Funds For Prescription Drug Monitoring

Dec 1, 2015

Credit Sharon Morrow

The manager for New Hampshire’s prescription drug monitoring program told lawmakers Tuesday that more funding would help the system to better handle an expected increase in use that could come with efforts to more closely monitor opioid prescribing.

As part of a special legislative session on heroin and opioid misuse, Gov. Maggie Hassan and Senate Majority Leader Jeb Bradley have each proposed giving the program $100,000 in state money to help with technology upgrades that would encourage more widespread use.

As it stands, the program operates largely through federal grant funding and cannot accept state money, but the proposals on the table would remove that limitation. Lawmakers will continue meeting to talk about additional proposals to address the state's drug epidemic in the weeks ahead, and members of a special task force are expected to publish a final report on its policy recommendations by early January.

Program Manager Michelle Ricco-Jonas told lawmakers during a task force meeting on Tuesday that doctors and other providers made 20,423 requests for patient data during the month of October. With a push toward more widespread use, that figure's likely to increase — and, in turn, the system itself will likely need to adapt.

"With increased utilization of the system, it's going to generate more data, and we have to be able to look at what the data is telling us," Ricco-Jonas said.

On Tuesday, Ricco-Jonas also outlined several other possible ways the program could put the added money to use, including: technical upgrades that would support mandated use of the program, upgrades that would enable daily reporting mechanisms (whereas reports are currently filed on a weekly basis) and a feature that would allow providers to include notes about a patient (if he or she has a pain agreement, for example) that could be shared with that patient's other providers.

New Hampshire became the 49th state to launch a prescription drug monitoring program in October 2014. According to the Prescription Drug Monitoring Program Training and Technical Assistance Center, it is one of 25 states that does not require participating providers to check the database when prescribing.

Program rules require that "all practitioners authorized to prescribe or dispense schedule II–IV controlled substances" in New Hampshire must at least register with the program.

According to data from the New Hampshire Prescription Drug Monitoring Program's annual report, more than half of the state's dentists, physicians, APRNs, physicians assistants, optometrists, pharmacists and podiatrists have at least registered for the program as of early September. Only about one-fifth of veterinarians had signed up by that date.

As part of the task force on opioid use, lawmakers are looking at ways to encourage or mandate more widespread use of the system in New Hampshire. Proponents of the system have argued that it's an important tool for identifying patients who might be "doctor-shopping" and to detect other outliers in prescribing patterns, like a doctor who might be writing more doses than his peers.

"We're kind of stopping the new abuse of opiates," Ricco-Jonas said. "We're not going to do anything about people who are currently addicted to opiates and may be progressing, but we are going to have an impact on people who will potentially begin a new pattern of abuse, and or have that lead to addiction."

The data doesn't provide a full picture of prescribing patterns in New Hampshire because it is not universally used in all medical facilities. But it does provide some insights into prescribing practices. The program's annual report, for example, includes data on the types of prescriptions being logged in the system, the extent to which patients are seeing multiple prescribers or dispensers, and more.