ALPENA - The Alpena County Prevention Policy Board, a multi-agency coalition of local leaders focused on curbing substance abuse, hopes to crack down on prescription drug abuse by encouraging local health care providers to use a state prescription monitoring program.
The Michigan Automated Prescription System keeps track of a patient's medications, their quantity and strength, the pharmacies that sold them and their dates of sale, and local doctors and pharmacists say it could seriously impede a patient's ability to doctor shop or otherwise divert medication as long as prescribers use it liberally. Dr. Steve Kallaway said MAPS checks and other narcotics-tracking documents like "pain contracts" are standard practice for most pain physicians already, but less so for primary care physicians, so excessive amounts of more generic medications like hydrocodone sometimes slip under the radar because their prescribers don't use MAPS. The board hopes to start a movement among local clinics and pharmacies toward using MAPS voluntarily and frequently, as the system is currently not mandated in some of the most abuse-heavy circumstances, and Kallaway said the cost-free system would be an easy preventative measure.
"It's all online, and it used to be a lot more difficult than it is. We, in fact, have our office staff do it for us. We'll just request one of our office staff members get a MAPS on this patient and it's run ... and it used to take a long time, but now you can have them within five minutes, or less than five minutes," he said.
Though HIPAA (Health Insurance Portability and Accountability Act) laws prevent physicians from reporting suspected medication abuse the way pharmacists can, local pharmacist Dr. Chris LeFave said physicians could voluntarily sandardize a handful of practices - doing MAPS checks before prescribing any kind of pain medication, on any quantity over 60 pills, or if they see a patient for a controlled substance more than once in 30 days - to identify and discourage doctor shopping. He also hoped physicians would start writing MAPS check dates on their prescriptions so he could start the practice of refusing to fill one without that information.
"It's possible that if we could get a small handful of physicians or clinics to agree ... to run MAPS on all controlled substances ... word will travel fast: Alpena County is not an easy spot to get a controlled substance filled," he said. "If we start with one doctor, one pharmacy, that becomes 10 doctors, all pharmacies in Alpena County. That could really easily be done."
The board found substance abuse in Alpena County has seen a recent downturn in many areas - Undercover Training for Intervention Procedures, intended to expose illegal alcohol sales, yielded no violations this year, and Judge Thomas LaCross said delinquency is down 50 percent from last year - but prescription drug abuse persists. Since he assembled a work group to confront the now-subdued synthetic drug problem, LaCross said he would like to see the group repurposed to address prescription drug abuse, and Kara Steinke of Catholic Human Services said members of the prevention policy board have already met with the director and sponsor of Alpena Medical Arts about using MAPS prior to prescribing Schedule 2 or 3 prescriptions, using pain management contracts, and regularly reviewing RX faxes from undercover narcotics programs. The board has also drafted a Prescription Drug Abuse Prevention Initiative, including specific objectives for education, advertising, medication collection, and social media.
County Prosecutor Ed Black said he would work with policy board members to draft language for a voluntary compliance certificate to which local clinics and pharmacies could agree, signifying their practice of using MAPS to identify possible prescription abuse.
Andrew Westrope can be reached via e-mail at firstname.lastname@example.org or by phone at 358-5693.