Demand the PMP

In my opinion a reasonable and prudent prescriber will access such a database at least once for any patient for whom knowledge of such drugs obtained from another prescriber. Failure to access information provided by state controlled substance prescription monitoring database constitutes negligence.

Almost all states now make these records available online, and we have had the PMP here in Washington for more than three years, but in conducting at least three independent examinations I conducted in the past year the treating physician failed to include a report from the PMP in the record. In at least two of those cases the physician told me or their patient they did not know of the existence of the database.

Though limited in other ways, the PMP report shows the drug, amount dispensed, prescriber, and pharmacy.

Use of many controlled substances can explain a variety of psychiatric presentations, and can contribute to dangerous interactions. Addicted patients may fail to tell other providers for fear of interrupting their supply of drugs, and prescribers often fail to communicate with one another to coordinate care.

Washington law does not permit forensic examiners to access the PMP. In one case I had to threaten to cancel an independent examination if the psychiatrist treating the subject did not provide a copy of the report. The threat worked. I encourage all forensic examiners to demand that treaters include current PMP reports with the usual medical records. Treaters should order them, too, especially if they prescribe controlled substances or treat patients with addiction problems.

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