In 2009, California Governor Jerry Brown announced a statewide database system designed to curb the illegal sale and distribution of prescription drugs like OxyContin and Vicodin. More than 40 states now have similar systems in place, but according to a recent article in The New York Times, California’s system seems destined to fail.
The purpose of a drug monitoring database like CURES (Controlled Substance Utilization Review and Evaluation System) is to allow pharmacists to look up the prescription histories of customers and refuse to fill prescriptions for individuals who appear to be abusing drugs. The database can also be used by physicians to determine if a patient has visited other doctors to obtain multiple prescriptions.
According to The New York Times, one of the fundamental problems with CURES is that enrollment in the system is optional. The Medical Board of California reports that there are more than 100,000 licensed doctors in the state, but only 8,000 physicians and pharmacists combined have enrolled in the system.
Another challenge to CURES is a lack of funding. Due to the state’s budget shortfall, Governor Brown recently cut $71 million from the Department of Justice budget. The 13-person staff that operates CURES was reduced to a single person. The system was shut down in late 2011; it was recently brought back online but few doctors or pharmacists have enrolled in 2012. There currently is no budget for CURES; its funding is provided by year-to-year grants.
Some doctors who use CURES have reported that the system is slow to respond and prone to errors. They are doubtful that the system could operate at all if a larger percentage of doctors enrolled. Mike Small, the lone Department of Justice employee who now maintains CURES, describes the three-year-old system as “old and falling apart.”
The federal government has expanded its response to prescription drug abuse due to the critical nature of the problem nationwide. The Centers for Disease Control reports that each year since 2003, more Americans died from prescription drug overdoses than from cocaine and heroin combined. In California, nearly 11 people die each day from prescription drugs. Options for help with painkiller addiction are plentiful but the instance of denial is also very high.
A 2011 survey of state drug monitoring databases found that 16 states proactively report to pharmacists and doctors about patients who appear to be doctor shopping. Several states also send reports to law enforcement agencies and to physician and pharmacist licensing agencies. In California, data collects in the system until a complaint prompts an investigation.
More than 20 states finance their drug monitoring database with fees collected from hospitals and drug manufacturers. Legislation that would have established similar fees in California was rejected by state lawmakers. According to Mary McElderry, an agent with the U.S. Drug Enforcement Agency, California is currently the only state in danger of losing its drug monitoring system.