Overdose deaths from opioids rose from 56,064 to 75,673 in the year ending April 2021. The number accounts for 75% of the 100,306 deaths that resulted from various drug overdoses in the same period. In addition to the toll it’s taken on many lives, an estimated more than $500 billion loss results from the opioid crisis annually, putting a massive strain on the healthcare system.
States are embracing technology to combat the national epidemic. Almost all states mandate EPCS use, and the remaining few are expected to require it at the beginning of 2023. At the heart of prescription opioid abuse are fraud and overprescription.
This post looks at ways EPCS is giving clinicians and pharmacists a tool to combat the opioid crisis.
Brief History of EPCS
In 2010 the DEA allowed the use of e-prescribing of controlled substances but under strict regulations. Initially, they worried that the system may have been easy to fake and do more harm in the fight against opioid abuse. As a result, controlled substances lagged even though the e-prescribing for other medications has been in effect since 2007.
The federal law on EPCS requires a rigorous clearance process before a prescriber can issue a prescription—an ID proof to show they are allowed to prescribe and two-step logical authentication to receive access control. Complex federal requirements make many prescribers and primary care facilities lag in adopting this technology.
Most states have mandated using EPCS to curb the opioid epidemic and controlled substance abuse, while in some, the mandate is coming into effect in January 2023. In some states, EPCS has to be used alongside the PDMP to ensure patients receive the correct dose.
How Prescription Opioid Is Contributing to Abuse
The following are ways legal prescriptions are contributing to the opioid crisis.
· Difficult to Track Prescriptions from Other Prescribers
A clinical prescriber can’t tell if the patient is receiving similar treatment from other prescribers with handwritten prescriptions. Also, without the patient’s medical prescription history, it’s hard to know if they are at risk of abuse or misuse, and you never know if they pick their prescription.
· Easy to Forge and Alter Doses or Steal Prescription Pads
Cases of patients stealing prescription pads and forging prescriptions are not unheard of. Patients alter legitimately handwritten prescriptions to increase the dosage, such as turning 1 to 4. Often it is either for illicit use or to feed a personal addiction.
· One Can Get the Same Prescription Filled by Multiple Pharmacies
Since tracking is impossible, patients get the same prescription filled by multiple pharmacies. Cases of some receiving drugs from multiple prescribers and filling them in different pharmacies within the same day are not uncommon.
· Unclear Prescriptions
Another problem associated with paper prescriptions is illegible handwriting. As a result, pharmacies issue the wrong dosage or have to make callbacks to the prescriber. When such prescriptions are presented during late hours, it is usually impossible to make the call.
EPCS Measures to Curb the Opioid Crisis
To curb the abuse of controlled substances, the DEA allowed using EPCS in 2010. E-prescribing provides a transparent and safe system for clinical prescribers to issue prescriptions safely. Under EPCS, clinical prescribers ‘write’ a patient prescription electronically and send it directly to the pharmacy eliminating paper prescriptions.
Some of the measures include:
· Monitoring and Oversight
The EPCS gives providers a means to monitor the patient’s prescription records. For instance, a provider can see all the medication previously prescribed by them or other clinicians. Also, those paid for by insurance or cash in the country are visible, making it easy to identify prescriber/pharmacy shoppers.
Since information regarding conditions that prompted a prescription in the first place is on record, a clinician can query the effectiveness of the treatment. You can identify patterns of patients with misuse or abuse tendencies from the patient’s history.
EPCS closes a significant gap by providing tracking absent in paper prescriptions. A clinician can tell if a prescription is filled or not. Also, a patient can’t fill a prescription more than five times. If this system is adopted in all the states, it will become impossible to perpetrate fraud of opioids and other controlled substances.
· Decision Support
Overprescription is a major issue regarding opioid abuse. EPCS can support clinical decisions to ensure the correct dosage is given. The CDC set guidelines for a safe prescription to prevent overprescribing controlled substances, including opioids. When these measures are integrated into the EPCS workflow in the EHR, an alert is triggered when the dosage is excessive or against set CDC limits.
Overprescribing has been identified as a significant problem leading to many overdose cases reported annually, some being fatal. But with EPCS, it will be difficult for patients to receive abnormally high doses.
· Lock-in Program for At-Risk Patients
The comprehensive addiction and Recovery Act calls for at-risk patients to get their prescription from the same pharmacy. Through EPCS, clinics can implement the directive for Medicare part D patients smoothly. Regardless of where the prescription is issued, they can only fill it from one pharmacy.
· Other Benefits
Facilities that have implemented EPCS have reported tremendous gains. Medical conditions such as back pain, abdominal pain, and dental pain requiring the prescription of opioids have reduced. It is estimated that such facilities make considerable financial savings.
In addition, patients’ wait time to pick up their prescription has lessened as the callbacks from pharmacies to prescribers. Compared to paper prescriptions, storing physical records is non-existent, saving on storage costs.
The opioid crisis requires the efforts of everyone, not just the government but also the public. Leveraging technology in the fight against opioid abuse helps on two fronts— by ensuring prescribers prescribe the correct dosages, sending them to the pharmacies, and preventing fraud and abuse, as seen previously through the issuance of paper prescriptions.
Federal law is soon going to require all facilities to be compliant, failure to which they will face penalties. Don’t wait to be caught flat-footed, be proactive. NewCropRX is ready to help you with compliance and security. In addition, you can be sure of all provider-patient history to make your diagnosis more comprehensive. All decision support regarding drugs, dosage, and interaction is also provided. Contact us for more information on how we can help you.