Danny asked
Hi, the short story of my question is this...a couple months ago I saw a dentist for an infected tooth because my regular dentist was out on vacation and it was an emergency. He gave me hydrocodone for the pain to get me by until I could see my regular dentist. The following month I go in to see my dentist to get it taken care of and he gives me hydrocodone again because it still hurt. Also that month I go in to see my regular family doctor to get my refills on my medications which include Xanax. Long story short he shows me a prescription monitoring sheet that shows I've gotten narcotics from multiple doctors and cuts me off of the Xanax and tells me the DEA is tracking me! I couldn't believe it. What does it mean that the DEA is tracking me? Am I in trouble or just being looked at?
Answer
Every state has in place some sort of prescription drug monitoring program, where every controlled substance medication fill for a patient is recorded and available for reference by medical professionals, law enforcement etc... In some states, your prescribing doctor will be legally required to look up your controlled substance fill history prior to writing you a prescription.
Prescription Drug Monitoring Programs
Prescription drug monitoring programs are in place for a variety of reasons including:
- Identify and deter/prevent drug abuse and diversion.
- Support access for monitoring controlled substance dispensing in a central database.
Before the programs existed, it was easy for individuals to "doctor shop", or go to different doctors who were not linked and fill controlled substances at different pharmacies to avoid detection. Now, since all controlled substance fills are recorded electronically in a central database, it is easy to identify potential abuse and diversion.
One of the potential downsides of these programs is the situation you described, where you are prescribed short term narcotics for something like dental pain from another provider and your primary care/pain doctor refuses to write anything for you based on this. Health care providers are very aware of potential "red flags" that they are presented with.
It is important to note that it is extremely unlikely that you are being "tracked" by the DEA. The DEA does not administer state drug monitoring programs, nor are they responsible for the continuous monitoring of individual patients. The DEA can certainly reference or use state monitoring programs as needed but again, the state in which you live is responsible for the monitoring and enforcement. In fact, the DEA specifically states the following:
"Each state controls who will have access [to the prescription drug monitoring program] and for what purpose...The DEA is not involved with the administration of any state PDMP."
What Is Looked For On Monitoring Programs
Now, prescription monitoring programs are perhaps most useful for identifying "red flags", or information that could potentially indicate abuse, diversion, addiction etc...Such red flags include:
- Prescriptions from multiple doctors.
- Dangerous combinations of controlled substances.
- Multiple pharmacies where prescriptions are being filled.
- Multiple emergency room visits where controlled substances were prescribed.
How your doctor responds to the information they see is up to them, based on their professional judgement and of course, the laws in your state.
It is extremely important that you communicate all prescription history, most importantly controlled substance fills, to your doctor. The worst thing that can happen is for your doctor to get surprised, or see something in your controlled substance fill history they weren't expecting.
DEA Role In Monitoring Programs
As stated above, it would be extremely uncommon for the DEA the track an individual patient in cases like yours. They are more responsible for monitoring prescribing doctors and significant cases of drug diversion and abuse. As the DEA monitors prescribing practices, many doctors are hesitant to continue to write prescriptions for an individual if they see any red flags, to be on the safe side. This unfortunately can harm patient care in situations where any perceived inappropriate action occurred.
Additional Information
Remember, the best thing you can do is to be transparent in regard to your controlled substance fill history and report anything that is done outside of the care of your primary care/pain doctor.
