Do police have access to pharmacy Rx history data?

In My Humble Opinion
1

Okay, we know from previous threads (I’m thinking of this one in particular, from about a year ago) that databases are kept of prescriptions filled by pharmacies, and that pharmacists are on the lookout for patients pharmacy-shopping for one who will fill their scripts.

My neighbor is worried about this. He’s been getting pain pills (some kind of opioid) at the local pharmacy. Suddenly, he encounters a pharmacist who’s on a “crusade” (as he put it), who refused to fill his Rx because he thinks there’s too much “history” there.

This is a small one-pharmacy town. So he now may need to drive to the next town over to get his Rx filled there.

Question #1: Now that one pharmacist has declined to fill his script, is he now red-flagged in some universal database, that will make it harder for him to get his script filled in any pharmacy from here to Alpha Centauri? (This is in California.)

Question #2: Do the police have access to a database of that sort? If he gets pulled over for a burnt-out tail-light, will the cop see that he has a history of suspected Rx abuse, and pull him aside for some extra-special attention?

(Note, I personally DON’T suspect that this neighbor has any drug abuse problem.)

2

Here is something that may answer your question. It is for the state of Connecticut I suspect similar things could be said about other states. I don’t believe that there is a database that the officer can access from his patrol car and pharmacies are not great at keeping up with databases of such things. I believe that the pharmacist does have the option of reporting suspected drug abusers to police though.

3

I am a psychiatrist and have worked in several states where I’ve had access to these state pharmacy reporting systems.

The databases aren’t “universal;” they’re run by state pharmacy boards so California’s is separate from all the others. The exception is that some states have reciprocal agreements with others, so that when you run a report, you can choose to see results from neighboring states. This can be helpful when you’re near a state border and someone could be doctor- or pharmacy- shopping by just going across the border.

There are no “red flags” in these databases. When you run a report on a patient, you get a list of all the controlled substance prescriptions they have had filled within a certain time frame, showing the drug, the dosage, the quantity of pills, the date it was filled, the pharmacy where it was filled, and the doctor (or prescriber) who wrote the prescription. How the person looking at the report chooses to interpret that information is up to them. I’ve even run a report on a patient who’d admitted to me that he’d been convicted of forging prescriptions, and there was no “ALERT! ALERT! This person is a DRUG SEEKER!” Just a list of the prescriptions he’d filled.

I’m not 100% sure, but in all the states where I’ve used these systems, in order to apply for access, you had to be a pharmacist, a prescriber, or a “delegate” of a prescriber (like a nurse who works in a doctor’s office and runs the reports for him.)

4

Question is answered.

Now, if your friend doesn’t want to have to leave town for his prescriptions…

He should first go to the original pharmacy and ask what exactly the problem was.

Second, depending on the answer, he should request that his doctor speak to the pharmacist.

If it is an honest concern about too many narcotics, the doctor should be able to put it to rest.

If it IS something hinky, then your friend will most likely be using a different pharmacy.

5

There is now a DEA database which track all Sch II (opioid) scripts to the individual.
The DEA is a police organization.
This went live in Jan or Feb 2017.

The MD now logs on, sends THIS script to THAT pharmacy in YOUR name.
You must produce “Valid ID” (google that one if you think Big Brother hasn’t yet arrived) to pick up the script.
These scripts cannot be refilled, cannot be called or fax’ed in - until the DEA DB went live, there was a high-security script form which had to be hand-carried from MD to Pharmacist.
Every 30 days.
After 12 years of that crap, the DB will seem like a godsend.

But yes, the primary reason for the DEA’s DB was the “pill shopping” user.

Yes, the patient should find out EXACTLY what is alarming the pharmacist. If the doc can’t get the pharmacist to fill the script, find another pharmacy.

6

Cite please.

7

You want a link to the DEA DB?

It is commonly referred to as “DEA”

How’s this: I watched the MD realize she had sent an opioid script to Walgreen’s mail-order center instead of the retail store.

I was not behind her, so I did not see the screens.

No script, but the pills were waiting for me at the pharmacy.

Since then I have had:
2 Fentanyl
3 Hydromorphone

scripts magically appear at the pharmacy window.
In Dec, it required me to hand the special blue scripts to the pharmacist to get opioids.

8

That is an e-prescription.

Prescription drug monitoring programs are state run. Not the DEA.

9

According to DEA

https://www.deadiversion.usdoj.gov/faq/rx_monitor.htm

They do not “actively” participate in the administration of these database - it is all by State.
It is just a coincidence that 49 States and Guam have all adopted identical databases and made them inter-operable.

10

They are in no way “identical”. Or in general “inter-operable”.

In fact, both of your cites have noted this.

11

Thanks for the conversation so far, people.

Anyone know how it’s done in California?

My neighbor (who I’m pretty sure is NOT a “drug seeker” or abuser) is of the opinion that that particular pharmacist is just an anti-drug “crusader”. Or, as suggested here and elsewhere, maybe just a bit paranoid about the rules. He says his first recourse will be the other pharmacist at the same store, who knows him better. But he’s really suddenly paranoid that now the police might single him out because he has a “record”. I hope it will calm him down to learn that the police don’t have such immediate access to all this – if that’s truly the case.

12

The California system is called CURES. Here is the URL:

They have a FAQ section.

IANAL and IANIC (I Am Not In California) but my WAG would be that police can gain access for the purpose of obtaining evidence pertaining to a case where someone is already under investigation for a crime pertaining to controlled substances, that they’re not randomly prowling the database looking for people to accuse of such crimes, and that to do so would be incredibly cumbersome, because their access looks like anyone else’s: they have to enter a first and last name and date of birth to look up one particular person at a time, and they’re not going to be doing that on their laptops during a routine traffic stop.

13

Here is a link to California’s program.

Interestingly CA does have an alert system for several categories.
Edit; Ninja’d!

14

Okay, I’ve just worked my way through the site that usedtobe linked. (As I’m typing this, I’m just noticing that Arcite and steatopygia have posted similar remarks here.) I found the California-specific page, and the corresponding FAQ.

In California, this program is run by the Department of Justice :eek: and it IS accessible to law enforcement. But there seems to be an implication somewhere that this is for cases under investigation, or prosecution, or otherwise with court orders – not for the cop-in-the-street to see. Although I’m not sure of that.

And yes, there are red-flag alerts for specific circumstances:

[quote=That California Drug-Tracking Program FAQ]
[ol][li] Patient is currently prescribed more than 100 morphine milligram equivalents per day[/li][li] Patient has obtained prescriptions from 6 or more prescribers or 6 or more pharmacies during last 6 months[/li][li] Patient is currently prescribed more than 40 morphine milligram equivalents of methadone daily[/li][li] Patient is currently prescribed opioids more than 90 consecutive days[/li][li] Patient is currently prescribed both benzodiazepines and opioids[/ol][/li][/quote]

The system includes a messaging system by which pharmacists can spread the word to a given patient’s other pharmacists. So it sounds like black-listing is very possible.

The page describes a somewhat difficult-sounding procedure for a patient to see his own record – it requires some formal application process with forms to fill out and submit somewhere. Now why does it seem necessary to make it difficult for a patient to see his own records?

15

The purpose of these databases is not law enforcement, it is to prevent people from going from Dr. to Dr. and obtaining prescriptions.

This used to happen ALL THE TIME. It still happens. Doctors don’t always check these when writing prescriptions. I have heard several reasons for this from different doctors. IMO they weren’t very convincing.

Additionally, if your friend has done nothing illegal, he has nothing to worry about anyway.

16

And if the local pharmacist STILL refuses to fill a legitimate prescription for something the patient NEEDS, a call or e-mail to the state licensing board may be warranted.

17

Just to add, PBMs (Pharmacy Benefit Managers) and health insurers have the ability to implement edits in their systems to identify, and in some cases intervene, in opioid abuse behaviors. For example, limiting fills and detecting refills too soon as well as pharmacy-shopping prevention. If the person has been with one insurer for a while, and they are developing such strategies, anyone with an opioid prescription may notice some differences. Plus, the insurer has a record of everything that person has done while accessing their benefits.

18

If the doctor is smart when a pharmacist starts questioning their prescriptions they will stop prescribing. Of late doctors have started being targeted and arrested by police for suspicious prescribing. I know a lot of doctors in my area refuse to prescribe opiates for that reason and my doctor at the VA is not even authorized to prescribe them.

19

Senegoid -

Thanks for the quote.
I am flagged for both opioids AND benzodiazepines.

And I am not a drug-seeking thrill pill popper.

I have both osteoarthritis (it got into my spine - the L4-L5 joint is a nightmare). I am going to be seen for surgery consultation, but until then, only opioids will control the quite serious pain.

I also have had real, every goddamn day insomnia since Junior High - 1961or thereabout.
Only a benzo will let me sleep.

I was once prescribed two benzos at a time. If mixed, they would produce a possibly fatal reaction.

I am still here. If I can keep those benzos apart, I think I can be trusted not to abuse drugs.

In case you are wondering - my bedtime dosage had benzo, lots of morphine (75mg in extended-release formulation), an anti-depressive known for sedation as a side effect, a few others.
And I added 250-300 ml of 100 proof vodka.

This formula is what is described as causing “accidental suicide” in people.

It got me to sleep (the benzo), kept the pain from awaking me (morphine) and let me wake up rested. The usual thing waking me was pain as the morphine wore off.
The first thing i did in the morning was to take 30mg morphine.

In the 14 years I have been using opioids for pain, I have had exactly 11 instances of a psychotropic reaction. IOW: for a total of 11 times, I got a buzz from an opioid.

I am not at risk of dying from OD - if I can do what I did for many, many years without harm, I think I can handle opioid + benzo.

But the database flags me as a problem, and they want to take away the benzo - without anything to replace it.
Yes, I DO resent the hell out of that damned flag.