A very controversial approach to prescription drug diversion and abuse that is used in at least fifteen states, and being considered in several others, is a prescription medication monitoring program.  One reason they are so controversial, and often lobbied against, are issues of privacy and doctor-patient confidentiality.  If handled properly, there is a positive healthcare related reason for endorsing these programs—they can help people as you saw in Part One.

Unless specific provisions for intervention and treatment are included in a monitoring system, many more people will be punished instead of helped.  The most significant opposition to the prescription monitoring system centers around the fear that big brother will use law enforcement to target people who, through no fault of their own, become addicted to the medication they were given to treat a legitimate medical condition.  In fact, many of them are not even addicted, but are on high doses of medication because after years of living with chronic pain, they have built up a high tolerance to it.

The other major concern is that unauthorized personnel might gain access to these monitoring records and use that information against them.  One documented case occurred in Nevada when a law enforcement officer, who was using OxyContin for an appropriate medical condition, was turned into his supervisor and subsequently fired.  There have also been reports insisting that in over 20 years there have not been any breaches of confidentiality in the fifteen states that currently have prescription monitoring programs.  Even so, there must be very stringent safeguards built into any prescription monitoring program to protect innocent people from unfairly targeted and harmed.

The solutions to the problem of prescription medication diversion are complex and need to be addressed not only by law enforcement, but also the healthcare industry.  With the quantity of Schedule II and Schedule III drugs continuing to increase significantly, the problem is only going to worsen.  Collaboration between law enforcement and healthcare providers is crucial.

Only by working together can appropriate solutions be found to use an effective tool like the monitoring program without it leading to the frightening predictions of the factions that oppose such measures.  In addition, healthcare providers and law enforcement personnel need to be trained to look for the early warning signs of both drug diversion and addiction.

This can be accomplished by using strategic research-based training protocols that educate healthcare providers and law enforcement professionals about discovering which patients are illegally diverting medication for profit, as well as focusing on prevention, intervention, and appropriate treatment strategies for legitimate addiction issues.  It is very important to have a strong focus regarding the ways in which healthcare providers and law enforcement can best collaborate when there is obvious criminal drug diversion activity.

I realize this is only a partial solution, but it is one that is desperately needed.  Each state should also form multi-disciplinary task forces that include all the segments of law enforcement and healthcare who are working together to combat this problem and save lives.  Educating the public, especially young children, about how to avoid an addiction trap is critical. 

In addition, we need to remember that although the vast majority of people with chronic pain may safely use pain medication.  Unfortunately, as many as 8.6 million people in 1999, to 11.7 million people in 2003, who used prescription drugs also suffered from coexisting abuse or addiction problems—these people need help, not incarceration.  However, people who are illegally diverting prescription medication for personal profit and greed need to be tracked down and prosecuted to the full extent of the law.

Unfortunately, prescription drug abuse or addiction is only one obstacle so to better understand the importance of overcoming obstacles to effective chronic pain management please check out my article, Overcoming Obstacles for Effective Pain Management, that you can download for free on our Ariticles page.

For an additional resource regarding medication management please go to our Publications page and check out my Addiction-Free Pain Management® Module Two: Examining Your Potential Medication Management Problems. To purchase this module please Click Here.

In Module Two you can explore the reasons people start developing problems with potentially addictive pain medication and define some often misunderstood terms. You can also examine the Red Flags Checklist to determine if there are any challenging medication management problems.  There is also a suggested APM Medication Management Agreement and information about how denial could prevent someone from following this plan.  Finally there is a safety plan designed to help people adhere to their Medication Management Agreement.  This safety plan includes developing a personalized craving management plan.

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