NEWARK
– Between November 3 and December 7,
2011, a single patient obtained a four-month
supply of oxycodone and methadone by presenting
prescriptions, now believed to be forged,
to three New Jersey pharmacies on a total
of 14 occasions. The patient circumvented
the safeguards that pharmacies and insurance
carriers use to spot such abuse by spreading
out his visits between the pharmacies, and
by paying with cash in some instances and
by insurance in others. As
a result, in one month the individual obtained
a total of 2,520 doses of highly addictive,
narcotic medications classified as Controlled
Dangerous Substances.
The
apparently abusive pattern of purchasing
drugs was revealed this month – and
the discovery was made thanks to the New
Jersey Prescription Monitoring Program (NJPMP).
Attorney
General Jeffrey S. Chiesa unveiled the NJPMP
as a powerful new tool in the State’s
fight against the abuse and diversion of
prescription drugs, and the often-heavy
reimbursement costs of fraudulently-obtained
prescription medication borne by health
insurance companies, the State, and ultimately
taxpayers.
Attorney
General Chiesa noted that prescription drug
abuse is growing at an alarming rate as
a threat to public health and safety:
- In
2010, New Jersey saw 7,238 admissions
to State-licensed or certified substance
abuse treatment programs as a result of
prescription painkiller abuse. That number
represents a striking 230 percent increase
from 2005, according to statewide statistics
collected by the Substance Abuse and Mental
Health Services Administration (SAMHSA)
- Every
day, 40 Americans die from abusing narcotic
prescription painkillers, according to
the U.S. Centers for Disease Control and
Prevention. Prescription drug abuse deaths
have more than tripled in the past decade
and now kill more people in the U.S. than
heroin and cocaine combined. Opioid pain
medication abuse accounts for the most
common poisonings treated in emergency
departments and nearly 1 million Americans
are currently addicted to some type of
opiate – costing insurance companies,
according to some reports, upwards of
$75.5 million a year.
- The
New Jersey State Commission of Investigation
in June 2011 reported that a growing number
of young people are abusing prescription
drugs, and noted a significant trend in
which young people who became addicted
to painkillers eventually turned to heroin
as a cheaper substitute.
The
NJPMP, established by State legislation
and maintained by the Division of Consumer
Affairs, has been collecting detailed data
from 2,000 pharmacies statewide since September
1, 2011. Pharmacies provide data every 15
days on all prescription sales of drugs
classified as Controlled Dangerous Substances
(CDS) and Human Growth Hormone (HGH).
The
result is a searchable database that includes
detailed information on the sale of these
high-risk drugs when they are dispensed
in outpatient settings in New Jersey, or
by out-of-state pharmacies dispensing into
New Jersey. The information on each transaction
includes, among other things: the patient’s
name and date of birth; the dates at which
the prescription was written and the drug
was dispensed; the name, quantity, and strength
of the medication; the method of payment
for the medication; and the identities of
the prescriber and pharmacy. The database
now includes information on approximately
4 million prescriptions dispensed in New
Jersey since September 1.
“The
New Jersey Prescription Monitoring Program
is one of several new tools in our statewide
effort to halt the abuse and diversion of
prescription drugs and promote fiscal integrity
in the healthcare sector,” Attorney
General Chiesa said. “The database
will help the Division of Consumer Affairs
and other law enforcement agencies identify
and investigate individuals and businesses
suspected of fraudulently diverting controlled
drugs for abuse. By highlighting the location,
nature, and extent of abuse throughout the
state, the information collected will also
better inform our healthcare initiatives
and addiction-treatment efforts.”
Patient
information in the database is kept confidential
in compliance with Health Insurance Portability
and Accountability Act of 1996 (HIPAA) and
Privacy and Security Rules. Under HIPAA
and the State law that establishes the NJPMP,
the Division of Consumer Affairs on January
4, 2012, began allowing State-licensed prescribers
and pharmacists to obtain free accounts
to access and search the database through
a secure website.
Registered
practitioners must certify they are seeking
data only for the purpose of providing healthcare
to current patients. Any practitioners who
access or share NJPMP data for any other
purpose are subject to civil penalties of
up to $10,000 for each offense, and disciplinary
action by the practitioner’s professional
licensing board.
The
Division of Consumer Affairs will also provide
case-specific NJPMP information to law enforcement
agencies, pursuant to grand jury subpoenas
or court orders and certifications that
the information is requested for a bona
fide investigation of a specific practitioner
or patient. In addition, the Division is
required to notify law enforcement agencies
or professional licensing boards if the
Division determines a prescriber, pharmacist,
or patient may have violated the law or
committed a breach of prescribers’
or pharmacists’ standards of practice.
“We
all know that prescription medication, when
used properly, can alleviate pain and illness.
The darker, lesser-known side of prescription
medication is that, when abused, it can
be just as dangerous, addictive, and deadly
as heroin,” said Thomas R. Calcagni,
Director of the New Jersey Division of Consumer
Affairs. “Nationwide surveys show
that many still mistakenly believe prescription
medication is harmless – and this
misperception is fueling a nationwide epidemic
that’s sending thousands of New Jerseyans
into addiction treatment centers each year,
and 40 Americans to the grave each day.
The NJPMP is an important tool in our statewide
effort to halt the soaring problem of prescription
drug abuse and diversion.”
The
January 2012 launch is the first phase of
a three-phase process during which the NJPMP
will be further enhanced and expanded, culminating
in approximately May 2012.
In
addition to its current application for
basic searches of patient- or prescriber-specific
information, the Division of Consumer Affairs
is developing enhancements that will enable
more complex, statistical analyses. When
fully expanded, the NJPMP will generate
reports on geographical areas with unusual
CDS or HGH prescription activity during
a specific time frame; identify practitioners
in each county who prescribed the largest
quantities of a specific drug during a given
time period; and provide other information
that can help identify and compare troubling
patterns of CDS and HGH activity.
Brian
R. Crowell, Special Agent in Charge of the
U.S. Drug Enforcement Administration, New
Jersey Division, stated, "The DEA New
Jersey Division is committed to fighting
the prescription drug problem with every
available tool possible in order to protect
our citizens. The New Jersey Prescription
Monitoring Program will serve as an invaluable
tool to thwart the spread of this significant
drug threat.”
High
levels of prescribing and dispensing of
controlled drugs are not necessarily indicators
of illegal activity or drug abuse, Attorney
General Chiesa noted. “While working
to stop abuse, we must remain mindful of
the legitimate uses for medication and ensure
practitioners are empowered to meet their
patients’ healthcare needs,”
he said.
Certain
medical practices, such as those that specialize
in pain management, prescribe larger amounts
of CDS medications than others during the
normal course of providing patient care.
The Division’s NJPMP Administrator
will work with investigators from the Division’s
Enforcement Bureau to analyze the information
behind NJPMP data reports.
“This
database is an important tool for physicians
and other health care practitioners to have
a complete picture of their patient’s
use of prescription medications that are
classified as Controlled Dangerous Substances
and Human Growth Hormones,” said Health
and Senior Services Commissioner Mary E.
O’Dowd. “With access to this
information, practitioners and pharmacists
will be able to identify an individual with
a possible substance abuse problem and refer
them to appropriate treatment.”
Jennifer
Velez, Commissioner of the Department of
Human Services, said, "The Department
is proud to partner with the Attorney General’s
Office on efforts to stem the misuse and
abuse of prescription medication. This new
tracking and monitoring system will serve
as a necessary safeguard and empower pharmacists
in prevention efforts, as well."
The
launch of the NJPMP is one component of
the Division of Consumer Affairs’
comprehensive effort to halt the diversion
and abuse of prescription drugs, which includes:
- Enhanced
enforcement initiatives, including a reorganization
of and additional staffing for the Division’s
Enforcement Bureau, which investigates
prescription drug diversion cases on behalf
of the State Board of Medical Examiners,
Board of Pharmacy, and New Jersey’s
other healthcare-related professional
licensing boards.
- Effecting
a reduction in supply, by encouraging
practitioners to prescribe only the amount
of medication needed for treatment; working
with pharmacies to develop a set of statewide
best practices for drug security; and
encouraging parents and grandparents to
maintain their medication securely within
the home, and to dispose of their unwanted
medications safely and responsibly through
Project Medicine Drop (see www.NJConsumerAffairs.gov/meddrop
for details), a pilot program providing
New Jerseyans medication disposal opportunities
24 hours a day, 365 days a year.
- Educating
constituencies, including an outreach
campaign for prescribers, pharmacists,
parents, and teenagers, about the dangers
of prescription drug abuse and ways to
prevent abuse.
- Enabling
recovery for persons struggling with addiction
by advancing measures that will facilitate
abusers’ access to treatment and
the treatment community’s access
to patient-specific prescription information.
For
much more information on the New Jersey
Division of Consumer Affairs’ initiative
to halt the diversion and abuse of prescription
drugs, view the Division’s NJPMP website
at www.NJConsumerAffairs.gov/pmp,
and the Division’s Project Medicine
Drop website at www.NJConsumerAffairs.gov/meddrop.
Follow
the Division of Consumer Affairs on Facebook,
and check our online calendar of upcoming
Consumer
Outreach events.
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