New roles for pharmacists in battle against addictions


COLUMBUS, Ohio — A tool for helping battle Ohio’s deadly addictions epidemic is adding new dimensions to the jobs of pharmacists.

A state computerized reporting system gives pharmacists quick access to patients’ prescribing histories as they weigh whether to fill suspicious prescriptions. It’s similar to systems in place or being developed across the country.

In January, California doctors, pharmacists and other health care providers began using a faster and more secure version of a database designed to prevent overdoses and illegal prescription drug sales.

The state Board of Pharmacy says Ohio’s system helped lower by 71 percent the number of patients going from doctor to doctor in search of drugs last year.

Kroger pharmacist Sarah Burke said the system is so easy to use she runs all prescriptions for controlled substances through it.

Burke said her interactions with customers now include awkward situations where she must occasionally turn demanding patients down.

“At the forefront I still want to keep my customer service even when faced with these tough interactions,” Burke said, taking a break from her job last month at a Kroger south of downtown.

“I still want to show empathy and understanding, but ultimately communicating that patient safety is my primary concern, and that’s why I’m taking the steps that I am to ensure that the medication is getting in the right hands,” she said.

The pharmacy board provides guidelines for handling such situations.

Accessing the Ohio Automated Rx Reporting System used to be a cumbersome process requiring pharmacists and other users to log out of one system and into another.

Last year, Gov. John Kasich, a Republican running for president, said Ohio would make up to $1.5 million available annually for prescribers to integrate their computer systems with the database.

To date more than 160 requests for access have come from hospitals, doctors’ offices, pharmacies and major health systems.

Ohio’s system allows pharmacists to check prescribing histories in Ohio and border states that have similar systems, including Indiana, Kentucky, Michigan and West Virginia.

Burke, 37, a pharmacist since 2003, spends most of her days making sure prescriptions are filled correctly and ensuring customers understand their therapy.

But sometimes problems arise, as when a patient showed up recently with a prescription for an unusually large amount of oxycodone — 180 tablets — with no history of similar prescriptions, according to the reporting database. He also wanted to pay cash, another flag.

Burke declined to fill the order, while saying she’d be happy to talk with his prescriber — an opportunity he turned down.

“I was able to say to the patient I’m uncomfortable with this therapy because I see that you’ve never been on it. It didn’t make sense in the course of routine prescribing,” she said.

The reporting system also caught the reverse situation with a different patient, a woman from West Virginia looking for Suboxone, a drug used to treat painkiller addiction but which has also been subject to abuse. The database showed the woman had received the drug from multiple pharmacies in recent months and Burke again refused to fill the prescription.

Pharmacists can refuse prescriptions for many reasons, including concerns the medication might harm the patient, suspicions of fraud, if the prescription is old or if it hasn’t been filled for the first time within six months of being written.

Confronting suspicious prescriptions is among the reasons the state is trying to make the database easier to use.

“It can be a difficult situation a pharmacist is in when a drug-seeking individual with a prescription is presenting at a pharmacy,” said Steven Schierholt, the pharmacy board’s executive director.

Beginning April 1, any South Carolina doctor who wants to bill either Medicaid or the state health plan must consult a statewide database of patients’ medical history.

Oklahoma Gov. Mary Fallin signed a bill into law last year requiring that doctors check a prescription drug database before prescribing certain addictive drugs to stop doctor-shopping addicts. Also last year, New Jersey Gov. Chris Christie signed a bill requiring pharmacists and doctors prescribing oxycodone and other controlled substances to register for access to the state’s Prescription Monitoring Program.

By Andrew Welsh-Huggins

Associated Press

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