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Two emergency medicine experts have proposed what they call “ideal” prescription drug monitoring software, in this week’s New England Journal of Medicine. The software would balance the needs of patients who suffer from chronic pain, with the need of policymakers to reduce the country’s growing prescription drug abuse problem, the experts say.

They state an ideal system would track and save patient prescriptions over time, according to Forbes. Doctors could check a patient’s past prescription drug use, to help them assess whether the patient’s reported pain is legitimate, and requires more medication. This could help doctors avoid asking patients for urine tests to check for traces of painkillers, which can lead to mistrust and resentment in patients, the article notes.

The system would alert doctors to unusual drug use patterns while the patient is still in the office. The database also would identify patients who are receiving multiple legitimate prescriptions for opioids or benzodiazepines and are at risk for complications from drug interactions. Prescribers would be given a unique code issued by the Drug Enforcement Administration, which they could use to detect forged or stolen prescriptions.

Some doctors object to current prescription drug monitoring programs, for a variety of reasons. These include concerns that the database programs could breach patient confidentiality, and interfere with needed pain treatment. They also worry that the databases could be used against doctors who need to prescribe high amounts of painkillers. Some physicians do not want to be required to consult the database every time they prescribe potentially addictive medication, and say it should be left to their discretion. They also say using the database is time-consuming.

Currently, 43 states have the databases, and another five states have passed laws to create them. Many prescription monitoring databases allow doctors and pharmacists to access information from neighboring states, which helps cut down on people driving across state lines to find more prescriptions.

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