In 2004, Maine’s prescription monitoring program was launched in response to drug abuse taking hold in the state’s rural counties.
Kurt Johnston, then a staff pharmacist at the VA Maine Health Care System in Togus, saw an opportunity to address the growing problem of opiate addiction among patients.
He and a colleague worked with VA computer technicians to submit veterans’ prescription histories to Maine’s new prescription monitoring system. Every two weeks, the data were loaded onto a CD, placed in an envelope and mailed to the state.
All was well until a few years later, when a representative from the vendor operating Maine’s prescription monitoring database at the time made a presentation at a national conference and highlighted Maine’s progress.
“Someone from central office VA happened to be in the audience and basically had a stroke when they saw that we were submitting data,” says Johnston, now chief of pharmacy services for the VA in Maine. “So I got a nasty phone call from Washington telling us in no uncertain terms to cease and desist.”
Federal regulations prohibited such disclosure of veterans’ health information.
Johnston stopped mailing CDs.
For years, prescription monitoring programs in Maine and many other states have operated without veteran prescription histories.
Now, after years of wrangling in Washington over legal and technical hurdles, veterans’ prescription histories finally will be submitted to state monitoring programs come September.
This closes a significant hole: Americans in the military are prescribed narcotic painkillers at three times the rate of civilians. The VA system issues almost 10 percent of all controlled substances in Maine.
Military personnel often are prescribed painkillers to treat service-related injuries and can become dependent on the medications.
Currently, health providers in Maine’s VA system can view data in the prescription monitoring program, but not submit it. That means a VA doctor or pharmacist would know if, for example, a patient was buying OxyContin at the local Target and Walgreen’s, but pharmacists at the two retailers may not realize the veteran also was accessing painkillers through the VA.
The information gap also opens the door to dangerous drug interactions.
“We can see what they did in the community, they can’t see what we did in the VA,” Johnston said.
All veterans prescribed opiates by the VA must sign a contract stipulating they won’t seek the drugs elsewhere.
But Johnston painted a picture of the pitfalls for a veteran who disregards that agreement: They visit a new doctor outside the VA system, feigning pain and asking for painkillers.
The new doctor checks the database, but can’t see that the VA is treating the individual and providing the same drug. The new doctor writes the prescription, asking the patient to sign another contract they have no intention of honoring.
“In September, we’re going to close the gate on that game,” Johnston said.