Everybody Hurts: Oklahoma navigates politics to require pain pill checks

Oklahoma is leading the nation in efforts to better track the distribution and use of addictive prescription drugs.

In April, Oklahoma Gov. Mary Fallin signed a bill that requires physicians to check a state-run database of patients and prescriptions before writing a new prescription for addictive medications. The support for the bill was tremendous, with the Oklahoma Senate voting 35 to 10 to approve it at Fallin’s urging.

“The goal of the bill is to stop doctor-shopping in the state of Oklahoma," Fallin said in an Associated Press story. "More Oklahomans die from prescription drug overdoses each year than they do from car wrecks in our state.” The AP’s Sean Murphy wrote:

According to statistics from the State Department of Health, Oklahoma's drug overdose rate increased by nearly 400 percent from 1999 to 2013, and the state currently has the sixth-highest unintentional drug overdose death rate in the U.S. Under the bill, doctors would have to access the database before prescribing certain highly addictive drugs or refilling prescriptions. The database, which is operated by the Oklahoma Bureau of Narcotics and Dangerous Drugs, includes real-time information on whether that patient has obtained prescriptions from another doctor.

Oklahoma – like California – has had the ability to track prescription drugs through this database for years, but California has made it voluntary for doctors to make use of the database. Perhaps the most interesting thing about this legislative victory for Fallin is that it came with the support of the state medical association.

Just a year ago, the Oklahoma State Medical Association and other medical industry groups were set against a law forcing doctors to check the prescription drug database. Warren Vieth at Oklahoma Watch and Jaclyn Cosgrove at The Oklahoman wrote:

In announcing the deadlock, the medical associations said they would not endorse the legislation unless it is scaled back to include only Schedule II narcotics and Schedule III drugs containing hydrocodone or codeine. They also oppose mandatory checks with every prescription refill. Instead, they want to limit the checks to the initial prescription, followed by annual follow-up checks for chronic-pain patients.

Initially, it seemed that the governor and her legislative allies were going to play hardball.

State Sen. A.J. Griffin wrote a version of the same bill for the Oklahoma Senate that would have required even more frequent checks. She told Vieth and Cosgrove that frequent checks were the only way to make sure patients weren’t becoming addicted and that they would not slow doctors down too much or compromise the quality of care. They wrote:

If many months pass between required checks, 'that’s plenty of time for someone to develop an addiction and plenty of time for someone to accidentally overdose,' Griffin said. 'It would not be a best practice when it comes to preventing addiction.'

Well, guess what? A year later, the medical associations were able to exact a host of concessions from legislators looking to pass the bill. In politics, you have to play ball, right? In future posts, I’ll detail those concessions and talk about what it might mean for California, which is considering similar legislation.

Photo by ashley rose via Flickr.