California Prescription Drug Monitoring Program: Managing Prescription Drug Abuse
California’s prescription drug monitoring program, the Controlled Substance Utilization Review and Evaluation System (CURES,) was established to combat the adverse effects of prescription drug abuse across the state.
The program promotes prescription drug safety and educates Californians on the dangers of prescription drugs.
What is Drug Diversion?
Not to be confused with programs that offer first-time offenders the chance to attend treatment instead of serving jail time, drug diversion refers to exchanging prescription drugs from the person holding the prescription to another party.
Within the CURES program, the term “drug diversion” refers specifically to the illegal exchange of prescription medications, including:
- transactions from a prescription holder to a person without a prescription
- the general trade of controlled prescription drugs without a valid prescription
Controlled Substance Utilization Review And Evaluation
CURES was established in 1997 as a possible replacement for the California Triplicate Prescription Program (TPP), the original program founded to gather Schedule II prescription drug data in California. From 1997 to 1999, the two programs ran concurrently.
When it was found that CURES was more effective at identifying instances of “doctor shopping” and prescription drug abuse, the CURES program was selected as the standalone monitoring program for the entire state.
Highlights Of The Cures Prescriptions Drug Monitoring Program
What Drugs Are Monitored By California’s Prescription Drug Monitoring Program?
Currently, CURES stores and reports all dispensation data for controlled substances in the following Schedules: II (2), III (3), and IV (4).
WHO HAS ACCESS TO THE PRESCRIPTION DRUG MONITORING PROGRAM (PDMP) DATA?
According to the California Health and Safety Code Section § 11165 (c), CURES PDMP data:
“…May be provided to public or private entities, as approved by the Department of Justice, for educational, peer review, statistical, or research purposes, provided that patient information, including any information that may identify the patient, is not compromised.”
This means that the only people with access to the data are those approved to have access, such as:
- agencies (that have been approved) using it for statistics and research
Not all physicians are required to use the data, and only doctors that have been approved will have access.
FACTS ABOUT THE CURES SYSTEM
- Pharmacists are required to report dispensations of controlled substances weekly.
- The Department of Justice does not modify any of the information within the system.
- Over 100 million entries have been entered into the California database.
- From 2011 to 2012, the program responded to 1,063,952 requests.
- In 2015, partially in response to the ongoing opioid epidemic, CURES 2.0 was introduced to fight drug diversion further and help stem the nationwide abuse of opioids.
- With CURES 2.0, prescribers were given the ability to create alert messages within the system. This feature allows doctors and pharmacists to alert each other about patients of concern and significantly reduce instances of “doctor shopping” when used correctly.
- The CURES system also helps track the dosages of methadone given to patients with addictions, identifying previous instances of methadone abuse that had gone overlooked.
- CURES 2.0 provides prescribers with information on patients who are or were previously prescribed opioids or benzodiazepines. A deadly combination, mixing these two medications, dramatically increases the likelihood of accidental, lethal overdose.
These alerts aim to protect patients from accidentally mixing the two drugs if two different prescribers prescribed them independently.
Shortfalls of Prescription Drug Monitoring Programs
While prescription drug monitoring programs are essential in modern times and have undoubtedly saved numerous lives, prescription drug abuse, overdoses, and black market sales of RX drugs remain prevalent.
A few shortfalls of the system include the fact that the PDMP are still running on a state-by-state basis, with each state responsible for implementing a PDMP and ensuring that the various state programs “speak” to each other.
Some have said that the biggest shortfall of PDMPs is that they cannot judge pain levels and that some patients have been “cut off” from their pain medications even though their pain levels are beyond manageable without the drugs.
Additionally, some argue that earlier years’ lax prescription practices led to people getting addicted to various prescription drugs. The new systems restrict access without diverting these individuals to addiction treatment.
The current heroin epidemic in the United States gives credence to this theory. Many heroin users surveyed in the United States stated that they turned to heroin after acquiring prescription painkillers due to PDMP restrictions.
Addiction Treatment for California Prescription Drug Addictions
With CURES already in place, it is becoming more difficult for California residents to abuse prescription drugs actively.
If you have a current addiction to prescription drugs or find yourself unable to stop taking a medication prescribed to you by your doctor, it is essential that you seek treatment immediately.
Prescription drug addiction can be stopped, and you can live a pain-free and comfortable life without drugs with the help of addiction treatment.
Alok Krishna, MD
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