As with many behavior problems, acknowledging that you have the problem is usually the first step to effective behavioral treatment. Unfortunately for children, we frequently skip right over behavioral treatment and give a drug, but that’s another subject. The point here is that, after tough questioning from Sheldon Whitehouse and others, the Drug Enforcement Agency (DEA) has recognized “the importance of establishing a rule to permit the responsible electronic prescribing of controlled substances.” But now they need to hand the issue off to two other huge bureaucracies, the Office of Management and Budget (OMB) and the Department of Justice, where solutions could be delayed for an undetermined amount of time. From the Whitehouse Press Office:
Studies show that widespread e-prescribing, used today in about 18 percent of doctorsâ€™ practices, could save $20 billion annually, as patients would experience fewer adverse drug events (ADEs) and would be more likely to adhere to a medication regimen. The Center for Information Technology Leadership (CITL) found that a national e-prescribing system could prevent 2.1 million ADEs –130,000 of which are life-threatening — and 190,000 hospitalizations per year.
Current DEA regulations require that doctors write paper prescriptions for controlled substances, such as pain medications, antidepressants and some drugs used to treat asthma in children. As a result, many doctors resort to writing all their prescriptions by hand rather than maintain a paper system for controlled substances and an electronic system for non-controlled substances.
During the Judiciary Committee hearing, Whitehouse and Senator Tom Coburn (R-Okla.) pressed DEA Deputy Assistant Administrator Joseph T. Rannazzisi, of the Office of Diversion Control, on DEA’s timeframe to revise the existing rules, stressing that further delay could slow the development and implementation of a nationwide, integrated system to support health information technology. “You’ve seen intense bipartisan concern about this. This is not an issue where we’re going to go away,” Whitehouse said at the hearing.
Rannazzisi agreed to inform the Committee, within two months, on when a proposed rule would be issued. Following the hearing, Whitehouse and 18 other senators wrote to Attorney General Michael Mukasey, asking him to review the issue and urging the Drug Enforcement Administration to issue new rules promptly.
As we create systems for e-prescribing, I hope we will also work on the problem of overprescribing, particularly as it relates to children and psychiatric care.