Pain - Additional Tools for Providers

Berkshire Health Systems has arranged for local healthcare providers to obtain certain additional tools that may be helpful in managing patients with complaints of chronic pain.

Massachusetts Department of Public Health Information
The Massachusetts Department of Public Health Drug Control Program includes a Prescription Monitoring Program that collects information on all Schedule II drugs dispensed in Massachusetts (the Department is currently seeking to expand the data base to include other scheduled medications). The Prescription Monitoring Program utilizes the data collected to determine prescribing and dispensing trends; provide educational information to health care providers and the public; and provides case information to regulatory and law enforcement agencies concerning drug distribution and diversion. Aggregate data and data without prescriber identifying information is available to the Community Pain Management Project. The Prescription Monitoring Program is working to make prescriber-specific data available at the request of or with the consent of the prescriber.

On at least a quarterly basis, the Community Pain Management Project intends to collect the aggregate and prescriber de-identified data for Berkshire County in order to observe and comment upon prescribing patterns and trends. The Community Pain Management Project also intends to collect (with prescribers' permission), or facilitate prescriber's in obtaining, prescriber-specific information in order to allow prescribers to compare their prescribing practices against those of their local colleagues. The goal of this informational effort is to allow prescribers to understand their own prescribing practices in the aggregate and in comparison to those of their peers in order to make any adjustment they believe appropriate. This prescribing information will also allow prescribers to identify situations of successful prescription forgery (e.g., one local prescriber discovered such a forgery when records concerning her prescriptions show instances of her prescribing certain opioids that she never actually prescribes).

Tamper-proof Prescription Blanks 
With the availability of sophisticated, but easy-to-use computer programs such as PhotoShop(r), it is increasingly possible for patients or others to manufacture realistic-looking, original prescriptions. There are now available on the market 'tamper-proof' prescription blanks that because of their design and features make counterfeiting extremely difficult.

Berkshire Health Systems has arranged for a supply of these 'tamper-proof' pads to be available to county prescribers at little or no cost above traditional prescription pads.

Warning Signs
In Massachusetts, it a crime, punishable by imprisonment for 4 years and/or a fine of $20,000 to 'knowingly or intentionally acquire or obtain possession of a controlled substance by means of forgery, fraud, deception or subterfuge, including but not limited to the forgery or falsification of a prescription or the nondisclosure of a material fact in order to obtain a controlled substance from a practitioner.' Massachusetts General Laws, Chapter 94C, §33. The crime expressly includes not only affirmative deception to obtain drugs, but also the failure to disclose a material fact in order to obtain the drug, such as the fact that the patient has already been to the Emergency Department or to another physician for the same purpose. An unsuccessful attempt to commit this crime is itself a crime under Massachusetts General Laws, Chapter 274, § 6.

Some physicians have found that posting a warning sign in the office describing the criminal statute has served as a deterrent to patients who might otherwise be tempted to seek pain medication for improper purposes. Berkshire Health Systems has arranged for the availability of 8-inch by 4-inch brass-colored signs that summarize the law and, if desired by the physician, warn of the office's policy of notifying the police in the case of violations.