Prescription drug abuse and drug overdoses are serious public health concerns within the United States. The U.S. Department of Health and Human Services (HHS) reports than an estimated 52 million Americans have misused prescription medications at least once in their lives. The Centers for Disease Control and Prevention (CDC) publishes that over 15,000 people died from a prescription opioid overdose in 2015, and every day, around 1,000 people are treated in emergency departments for the misuse of these medications.
Overdose death rates spiked more than 16 percent in New Jersey from 2014 to 2015, as more than 1,400 people died from a drug overdose in 2015, the CDC reports. In just five years, from 2005 to 2010, New Jersey saw an increase of over 5,000 people seeking treatment for prescription pain reliever abuse and/or addiction, the New Jersey Division of Consumer Affairs publishes.
In an effort to stem this dangerous tide of prescription drug abuse, Governor Chris Christie launched the New Jersey Prescription Monitoring Program (NJPMP) to help prevent opioid drug abuse and addiction in 2011. Pharmacies are expected to submit data pertaining to prescriptions of controlled dangerous substances (CDS) and human growth hormone (HGH) that are dispensed from out-of-state pharmacies into New Jersey, and also from outpatient facilities within the state, to the NJPMP statewide database. This program is designed to help pharmacies and providers keep track of potentially dangerous medications and identify people who may be at risk for abuse and addiction.
The NJPMP is part of the New Jersey Division of Consumer Affairs’ initiative that strives to prevent prescription drug abuse and diversion by keeping track of who is prescribing, and being prescribed, controlled substances like opioid painkillers. Prescription opioid drugs are classified as Schedule II controlled substances by the Drug Enforcement Administration (DEA) due to their high rate of diversion, abuse, and addictive potential. Pursuant of the NJPMP, pharmacies are required to report information on both CDS and HGH drugs to the database on a daily basis, no more than one business day after the medication is dispensed.
Prescribers, prescriber delegates, and pharmacists licensed by the State of New Jersey and in good standing with their respective licensing boards can access the NJPMP before prescribing or dispensing these controlled medications to ensure that it will be safe to do so. Prescribers who are registered with the NJPMP can authorize other specific healthcare providers who meet strict criteria as delegates to then access the NJPMP on their behalf, the Division of Consumer Affairs reports. Registered nurses, dental hygienists, licensed practical nurses, physicians’ assistants without prescriptive authority, advanced practice nurses without prescriptive authority, and registered dental assistants and certified medical assistants (CMAs) who meet certain requirements (as well as medical and dental residents who are authorized by a teaching faculty member) may be delegates. These delegates must also register with the NJPMP in order to access the database.
Patient privacy is protected by HIPAA (Health Insurance Portability and Accountability Act of 1996) Privacy and Security Rules. Information is therefore kept confidential and only accessible to registered users.
A pharmacist who is registered and has access to the NJPMP can look up a person’s medication and prescription history before dispensing drugs. The first time a Schedule II drug is prescribed for chronic or acute pain, the pharmacist (or their delegate) is to access the NJPMP and check on the person’s medication history. Pharmacists are then required to continually check in with the database on a quarterly basis (every three months) if a patient is receiving this kind of prescription. This can help them to spot potential drug-seeking behaviors or patterns of abuse.
Individuals who struggle with addiction to prescription drugs may attempt to “doctor shop” (try and obtain multiple prescriptions from different sources) in order to get more drugs. Prescription drug monitoring programs can help to stop this from happening. The NJPMP can also help to identify “pill mills,” or pharmacies that dispense medications without genuine medical necessity. Opponents of these drug monitoring programs voice concern that it may hamper a person’s ability to easily obtain these prescriptions when they are actually medically necessary.
The NJPMP is a national program. In June 2017, West Virginia, Pennsylvania, Maine, Massachusetts, and New Hampshire joined New York, Rhode Island, Minnesota, Delaware, Connecticut, South Carolina, Virginia, and New Jersey as participants in the program, the Press of Atlantic City reports. Over 50 million records of prescription drug dispensing and prescribing are contained within the comprehensive NJPMP database, the State of New Jersey Department of Human Services publishes.
Addiction is a disease that can easily cross state lines, and by having multiple states involved in drug monitoring programs with an easily searchable database, drug misuse and diversion can be more easily prevented. Individuals can no longer just cross the state border in order to find these medications at alternate pharmacies or prescribers. The breadth of this national database can help providers to identify people who may be at risk for drug misuse and/or addiction. Instead of being prescribed medications that may be potentially harmful, providers can then offer referrals for drug abuse and addiction treatment services to ensure that this population, which may have been overlooked before, is now able to get the help they need.
The New Jersey Controlled Dangerous Substances (CDS) Act places strict regulations on drugs that have a high potential to be diverted and abused, and that can be habit-forming. A component of the Department of Law and Public Safety, the Drug Control Unit enforces the provisions of the CDS Act, making sure that providers and prescribers are registered and also running the New Jersey Prescription Blanks (NJBP Program) to help prevent fraudulent prescriptions from being written and dispensed.
New Jersey has also instituted Project Medicine Drop that has set up medicine drop boxes all over the state for individuals to dispose of potentially dangerous prescription drugs in solid form (no syringes or liquids), that may be either unused or expired, with no questions asked. Drop boxes are anonymous, open seven days a week, and serve to keep these prescription drugs out of the hands of people who may seek to misuse them.
The NJPMP is a useful tool with several facets that can help prescribers and medical providers to recognize behaviors and patterns of drug use that may be harmful. Once a concern is raised, the provider can help the individual to find local assistance. It can also serve to work as a preventative tool, making these potentially dangerous controlled substances harder to obtain access to and therefore making them less likely to be diverted and abused.
Opioid addiction is a national epidemic, with the American Society of Addiction Medicine (ASAM) reporting that close to 2 million Americans struggled with addiction to prescription opioid painkillers in 2015. These drugs can cause drug dependence even when used as directed and with a necessary medical reason, which may in turn devolve into compulsive drug use and addiction. Prescription drug monitoring programs may help to stop addiction before it starts.