The envelope read: "Department of Justice: Bureau of Narcotic Enforcement". I opened it with trepidation because this report tells me if someone is cheating on me or not. No one likes to be crossed and doctors are no different. Sure enough, the person that I suspected was in fact getting medications from different doctors, in different towns, from different pharmacies. I felt so betrayed and sad. The trust that I gave this patient, who said she was in pain, was shattered in an instant. Will she be back? Probably not, these types use, abuse, and move on to find another victim.
Most of the letters that I get from the Department of Justice (DOJ) confirm that my trust is well placed; but sometimes, I do catch a cheater. And every time I catch one, it hurts and undermines my ability to trust others.
When I became a doctor, I did not know that I would also have to police my practice with the help of the law enforcement agencies. But, as a prescriber of pain medications, I am obligated to "monitor" for inappropriate use. Urine drug testing is just one way to catch a cheater. Patient Activity Reports from the DOJ are another. These reports list all schedule II, III, and IV drugs, prescribers and pharmacies that were obtained by an individual. In the very near future, these reports will be available online, in real time. All licensed healthcare professionals have access to this valuable tool "in order to prevent the inappropriate, improper or illegal use of Schedule II, III, and IV controlled substance". Once obtained, this information becomes part of a patient's medical records and is kept confidential. In fact, most people do not know that their information has been checked through the DOJ. When I do tell someone about the check, that person is either offended or understanding. Either way, this monitoring serves a valuable purpose-safety.
As a doctor, I feel morally obligated to insure that the medicines I prescribe will not jeopardize the safety of an individual or the public. If someone is getting medications from multiple sources, too many "cooks" in the kitchen and mixing of incompatible "ingredients" can lead to disaster. That is what happened when Bob Pack's children were killed by a driver under the influence of multiple drugs obtained from multiple doctors. Now, the Pack Foundation privately funds the California program that tracks prescription drugs. This system raises awareness levels and awareness translates into improved safety. In healthcare, safety should come first.
Tracking prescription drugs can not only help to identify cheaters, but can also help to identify potential safety hazards. Either way, I am thankful to have this tool available even though the information obtained can sometimes wound my heart when I discover that I have been betrayed by a cheater.
Published On: October 13, 2009