DEA and Prescription Drug Database Access

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Dr. Emory: shut up. You clearly have no idea what you are talking about. She wants rp protect drug dealing and non medical use of opiates. At least that is the jist of her position in the article.
 
IMO physian reviews of the PDMP should be mandatory. I also think that are medical boards should be proactive with this tool, rather than complaint driven. The PDMP is a powder keg of 'potential' harm.
 
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I disgaree with PDMP before all RX. I prefer to retain the ability to use my noggin and discretion. Use it when I have concerns. Great tool but not every project needs the same tool
 
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I disgaree with PDMP before all RX. I prefer to retain the ability to use my noggin and discretion. Use it when I have concerns. Great tool but not every project needs the same tool

One of the cardinal sins of opiate prescribing. Why use your best guess when hard data will end the doubt?
 
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I disgaree with PDMP before all RX. I prefer to retain the ability to use my noggin and discretion. Use it when I have concerns. Great tool but not every project needs the same tool
Sounds like if you are not using the PDMP as a resource on opiod rx , you are not using your Noggin, and like they say "discretion is the better part of valor"
 
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just to be clear, y'all are advocating for pdmp for every single opioid rx; new, refill, acute, chronic, without exception? your stable pt you are seeing for the last 5 years, 100% compliant, prior normal UDT, no red flags, prior normal PDMP, recheck every RX? seems overkill IMO.
 
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just to be clear, y'all are advocating for pdmp for every single opioid rx; new, refill, acute, chronic, without exception? your stable pt you are seeing for the last 5 years, 100% compliant, prior normal UDT, no red flags, prior normal PDMP, recheck every RX? seems overkill IMO.

Every new, every early out, every inconsistent pill count, every abnormal UDS, and sometimes "just because..."
 
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You are using your judgement which is square with how I plan to use PDMP (PDMP new to my state).
 
just to be clear, y'all are advocating for pdmp for every single opioid rx; new, refill, acute, chronic, without exception? your stable pt you are seeing for the last 5 years, 100% compliant, prior normal UDT, no red flags, prior normal PDMP, recheck every RX? seems overkill IMO.
yes.
1. required in my state.
2. amazing how you find things that change in less than 4 weeks.

one patient, a stable pt "i" was seeing for the last 5 years, 100% compliant, prior normal UDT, no red flags, prior normal PDMP... got 20 hydrocodone script from 1 ED, 2 bottles of hydrocodone elixir from dentist and PCP, all within 2 weeks.

or the other "stable" patient 100% compliant with normal UDT, no red flag, prior nml PDMP (but not complete because this was at start of data collection) - double dipping with getting twin scripts from this office and PCP.

3. i wish i could check PMP on those patients i discharged for violating treatment agreements, just for kicks, but....
 
I'm running you guys as I type:)
 
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just to be clear, y'all are advocating for pdmp for every single opioid rx; new, refill, acute, chronic, without exception? your stable pt you are seeing for the last 5 years, 100% compliant, prior normal UDT, no red flags, prior normal PDMP, recheck every RX? seems overkill IMO.
You're not charged by each time you access it, are you? And is your practice THAT busy that you can't do it?
If you are relying only on your patient being compliant with office visits, and you only have 1 UDT in these past 5 years, and you won't be checking the PDMP, that sounds like you have blinders on.
 
just to be clear, y'all are advocating for pdmp for every single opioid rx; new, refill, acute, chronic, without exception? your stable pt you are seeing for the last 5 years, 100% compliant, prior normal UDT, no red flags, prior normal PDMP, recheck every RX? seems overkill IMO.
I started doing pdmp checks for every Rx. Overkill? Maybe, but until this Rx OD epidemic ends, I want to be the guy doing a little more than necessary, not the guy doing a little less. Especially, if your state allows delegates, just have your MA delegate pull it up and alert you of there's any names on there other than you. If not, document "consistent."

I've also starting documenting a D.I.R.E. score on everyone, not because I think these risk tools are validated but just more evidence I'm looking out for abuse/diversion. If my stuff gets audited, I want an airtight defense.
 
You're not charged by each time you access it, are you? And is your practice THAT busy that you can't do it?
If you are relying only on your patient being compliant with office visits, and you only have 1 UDT in these past 5 years, and you won't be checking the PDMP, that sounds like you have blinders on.

Nooo, I dont do UDT every 5 yrs. Dont jump to conclusions. Boy, some you guys have gotten cranky since I was on here last. I understand everyone is frustrated with the state of medicine but why all the friendly fire? I am asking questions and offering discussion, the personal attacks are not adding to the discussion IMO. FYI I do UDT at least annual, more often on any signs of abberancy. I am in general stingy with opioids. I prefer to select well up front and avoid issues later.
 
If it is part of the work you do and treatment decision, not charting is crazy. Unless the state says you have to check but cannot detail data in chart. I pity the states that are that fd up.
Check your state PMP law, you might be surprised. Mine says you can check it, you can discuss it, you can document relevant portions in the chart, but specifically states you cannot give the printout to the patient (only a state PMP official can) and you cannot put the actual printout into the chart. I'm told the reason is that since others reading the charts may not be signed up for the PMP (such as nurses, other physicians, insurance agents and allied health people down the line) you're technically giving non-registered people access to it, it you put it in the chart for all of eternity. It kind of makes sense. I was very surprised to find out my state's PMP laws read like this, but it does. Check, you may be surprised.
 
Check your state PMP law, you might be surprised. Mine says you can check it, you can discuss it, you can document relevant portions in the chart, but specifically states you cannot give the printout to the patient (only a state PMP official can) and you cannot put the actual printout into the chart. I'm told the reason is that since others reading the charts may not be signed up for the PMP (such as nurses, other physicians, insurance agents and allied health people down the line) you're technically giving non-registered people access to it, it you put it in the chart for all of eternity. It kind of makes sense. I was very surprised to find out my state's PMP laws read like this, but it does. Check, you may be surprised.

That makes absolutely no sense, anybody in the chart is bound by HIPPA policies. Can you post a copy of your State's PMP law?
 
Check your state PMP law, you might be surprised. Mine says you can check it, you can discuss it, you can document relevant portions in the chart, but specifically states you cannot give the printout to the patient (only a state PMP official can) and you cannot put the actual printout into the chart. I'm told the reason is that since others reading the charts may not be signed up for the PMP (such as nurses, other physicians, insurance agents and allied health people down the line) you're technically giving non-registered people access to it, it you put it in the chart for all of eternity. It kind of makes sense. I was very surprised to find out my state's PMP laws read like this, but it does. Check, you may be surprised.

Nothing I can find on Georgia law web and GDNA website.
 
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