Are State Controlled Substance Monitoring Systems Linked?

Yes, most states do share controlled substance dispensing data.

Question

My brother is a "know it all" and I do not believe what he has told me. According to him, a person can fill a prescription like hydrocodone in one state and then again in another state a week or two later for the same medication (new prescription written by a Dr in the state). I say they cannot get a new prescription filled in a different state because of PMP laws and states share this info. My brother says if one pays cash there is no prescription trail. Please give your expert take on this.

Asked by RobMac On Oct 20, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Oct 22, 2018
Prescription Drug Bottles

Overview

All states (except for Missouri) have prescription drug monitoring programs that track an individual's controlled substance fill history.

These monitoring programs are often referred to as 'Prescription Monitoring Programs' (PMP) or 'Prescription Drug Monitoring Programs' (PDMP).

The purpose of these programs are to allow designated individuals to search for and access the controlled substance fill history for a particular patient, with the goal being to reduce drug abuse and diversion.

An important point about these programs is that they are run by individual States, NOT the DEA. Direct from the FAQ section of the DEA website:

"The DEA is not involved with the administration of any state PDMP."

The rules of each individual program, and the data that is collected, is not universal. Variations among the programs include:

  • Origin of prescription (e.g. inpatient, outpatients) that must be recorded.
  • Quantity limit of controlled substance to be recorded.
  • Mechanisms for reporting and accessing data.
  • Minimum day supply dispensed that must be recorded.
  • Frequency of data upload to the program.
  • Who can access the data.
  • Schedule of drug that must be recorded.

Prescription Monitoring Programs By State

With the exception of Missouri, every state (and the District of Columbia) have a prescription drug monitoring program, which are detailed in the chart below.

StateProgram
AlabamaPrescription Drug Monitoring Program
AlaskaPrescription Drug Monitoring Program
ArizonaPrescription Monitoring Program
ArkansasPrescription Monitoring Program
CaliforniaCURES (Controlled Substance Utilization Review and Evaluation System)
ColoradoPrescription Drug Monitoring Program
ConnecticutCPMRS (Connecticut Prescription Monitoring and Reporting System)
DelawarePrescription Monitoring Program
District Of ColumbiaPrescription Drug Monitoring Program
FloridaE-FORCSE (The Electronic-Florida Online Reporting of Controlled Substances Evaluation)
GeorgiaPrescription Drug Monitoring Program
HawaiiPrescription Monitoring Program
IdahoPrescription Monitoring Program
Illinois

Prescription Monitoring Program

IndianaINSPECT (Indiana Scheduled Prescription Electronic Collection and Tracking Program)
IowaPrescription Monitoring Program
KansasK-TRACS (Kansas Tracking and Reporting of Controlled Substances)
KentuckyKASPER (Kentucky All Schedule Prescription Electronic Reporting)
Louisiana
Prescription Monitoring Program
MainePrescription Monitoring Program
MarylandPrescription Drug Monitoring Program
Massachusetts
Prescription Monitoring Program
MichiganMAPS (Michigan Automated Prescription System)
Minnesota
Prescription Monitoring Program
MississippiPrescription Monitoring Program
MissouriNo State Program - Certain Counties Have One
MontanaMPDR (Montana Prescription Drug Registry)
NebraskaPrescription Drug Monitoring Program
NevadaPrescription Monitoring Program
New HampshirePrescription Drug Monitoring Program
New JerseyPrescription Monitoring Program
New MexicoPrescription Monitoring Program
New YorkI-STOP PMP
North CarolinaNCCSRS (North Carolina Controlled Substance Reporting System)
North DakotaPrescription Drug Monitoring Program
OhioOARRS (Ohio Automated Rx Reporting System)
OklahomaPrescription Monitoring Program
Oregon
Prescription Drug Monitoring Program
Pennsylvania
Prescription Monitoring Program
Rhode IslandPrescription Drug Monitoring Program
South CarolinaSCRIPTS (South Carolina Reporting & Identification Prescription Tracking System)
South DakotaPrescription Drug Monitoring Program
Tennessee
CSMD (Controlled Substance Monitoring Database)
TexasPAT (Prescription Access in Texas)
UtahCSD (Controlled Substance Database)
VermontVPMS (Vermont Prescription Monitoring System)
VirginiaPrescription Monitoring Program
WashingtonPrescription Monitoring Program
West VirginiaCSAPP (Controlled Substances Automated Prescription Program)
Wisconsin
Prescription Drug Monitoring Program
WyomingWORx (Wyoming Online Prescription Database)


Interstate Sharing

Although every state administers and maintains their respective prescription drug monitoring program, over 45 participate (or are scheduled to participate) in interstate sharing of data. They are:

  • Alaska
  • Alabama
  • Arizona
  • Arkansas
  • Colorado
  • Connecticut
  • Delaware
  • District of Columbia
  • Georgia
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Montana
  • Mississippi
  • Nevada
  • New Jersey
  • New Hampshire
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Rhode
  • Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • West Virginia
  • Wisconsin

Interstate sharing of prescription monitoring program data is facilitated by 'NABP PMP InterConnect', which is described as:

"The benefits of state PMPs are enhanced by PMP InterConnect because the system provides the means for physicians and pharmacists to more easily identify patients with prescription drug abuse and misuse problems, especially if those patients are crossing state lines to obtain drugs. Utilizing the program’s connected web of information allows appropriate intervention and aid in the prevention of substance abuse and diversion of controlled substances."

Below is a map showing all InterConnect participants:

States That Share PMP Data
Source: NABP

The sharing of prescription drug program data between states is still relatively new, as InterConnect was only introduced in 2011.

Each state varies in regard to who can access out-of-state data, and how accessible it is (i.e. permission for an individual to access another state’s data varies between states.)

Some states, like New York, allow users of the PMP to easily search the fill history of an individual in New York and many of the participating InterConnect states. Other states may require a specific request that takes additional time to complete.

Nevertheless, if your state participates with InterConnect, fill history can be accessed out-of-state in one way or another.


Final Words

Most states participate in the 'interstate' sharing of prescription drug monitoring program data. Whether or not this data is readily accessible depends on the state in question as each individual state has its own rules concerning who may search its registry and what data it provides.

To touch on the situation you described, paying 'cash' in two different states (resulting in no prescription trail), was at one point true but is no longer the case in most situations.

Historically, it was an individual's insurance company that would 'flag' a pharmacy/pharmacist regarding a similar/same drug fill, regardless of filling location.

If you got your prescription without involving your insurance, it would be very difficult for a pharmacist or law enforcement to track it.

However, with the advent of prescription monitoring programs (PMPs) and the sharing of prescription fill data, it is much easier for a health care professional to have a complete fill history for a patient.

In fact, some states require a health care professional check their respective states PMP prior to writing (or dispensing) a controlled substance prescription.

Although the recording and sharing of data has come a long way, there may be a particular situation where the data between two states isn't linked... for now. Moving forward, this will be become more and more uncommon.


Summary

  • Every state, with the exception of Missouri, has a state-run PMP (prescription monitoring program).
  • Most states participate in 'interstate sharing programs' and therefore, your controlled substance fill history is accessible in most in states, not just the one you live in.

  • References
    1. NABP PMP InterConnect: The Only National Network of State-Based PMPs. AccessFDA
    2. Pharmacist's Letter Prescription Monitoring Programs. Pharmacist's Letter (Subscription Required)
    3. State Prescription Monitoring Programs. DEA

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    Dr. Brian Staiger Pharm.D

    Dr. Brian Staiger is a licensed pharmacist in New York State and the founder of PharmacistAnswers.com. He graduated from the University At Buffalo with a Doctor of Pharmacy degree in 2010. He has been featured in numerous publications including the Huffington Post as well as a variety of health and pharmacy-related blogs. Please feel free to reach out to him directly if you have any inquiries or want to connect! He's answered thousands of medication and pharmacy-related questions and he's ready to answer yours! Brian.Staiger@PharmacistAnswers.com Office: 716-389-3076

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