Tracking database for narcotic prescriptions debated

Although one very prominent physician has spoken out against it, one medical society is promoting the idea of a national database to track narcotic prescriptions.

The National All Schedules Prescription Electronic Reporting Act, which was approved by the U.S. House of Representatives Oct. 5, is aimed at preventing interstate "doctor-shopping" by people seeking multiple prescriptions of controlled substances. But critics, including U.S. Rep. Ron Paul, MD (R, Texas), consider it another example of government meddling in the delivery of appropriate pain medicine.

"I think it's atrocious, and it so undermines medicine and the care of the dying," Dr. Paul said. "No matter how well intended, there's going to be unintended consequences, and it's going to make things worse."

He added that one result of prescription-monitoring programs is that "doctors become the criminals," but Paducah, Ky.-based pain specialist Laxmaiah Manchikanti, MD, said NASPER is designed to prevent that.

President of the American Society of Interventional Pain Physicians, which is lobbying for the bill's passage, Dr. Manchikanti said prescription-monitoring programs can create the problems Dr. Paul fears, but NASPER is patterned after "physician-friendly" programs operating in Kentucky, Nevada and Utah. These plans, he said, alert physicians when patients might be doctor-shopping.

Dr. Manchikanti said he became more acutely aware of the need for a database after opening an office in Illinois. The state has a monitoring program but does not provide him with the data that Kentucky's system does.

NASPER was sponsored by Rep. Ed Whitfield (R, Ky.). A Senate version, co-sponsored by Sens. Jeff Sessions (R, Ala.) and Dick Durbin (D, Ill.), was introduced Nov. 19. The AMA and the American Academy of Pain Medicine haven't taken a position on the bill.