Audit Follow-Up Finds Oregon’s Program for Monitoring Opioid Prescriptions Still Falls Far Short of Best Practices

Secretary of State Shemia Fagan today released the results of a follow-up to a 2018 audit of the state’s prescription drug monitoring program.

The 2018 audit found that the PDMP, which was created to reduce the number of opioids improperly or overprescribed, was far less effective than it could be. That audit included 12 recommendations for making the program, which is supposed to allow prescribers and regulators to track potential abuses, more effective.

The follow-up report found some progress, but noted that gaping holes still exist.

That matters because the state has a giant opioid problem. “Oregon has the highest rate of misuse of prescription opioids in the nation,” auditors noted. “Although Oregon is dispensing fewer opioid prescriptions, it is still prescribing at a higher rate than the national average.”

Of the dozen recommendations for improvement they recommended in 2018, auditors found that the Oregon Health Authority, which oversees the program, had fully implemented four and partially implemented three. But four years after they diagnosed major loopholes in the program, auditors found that some of the most critical gaps still exist. Prescribers are not required to participate, for example, and those who do are not required to query the database before writing a prescription, which could negate the value of the system.

“Oregon does not require all prescribers or pharmacists to use the PDMP database prior to writing or dispensing controlled substance prescriptions,” the auditors found. “Also, other states allow their PDMP to share information proactively with stakeholders to help monitor and address questionable prescription activity and collect some additional prescription information that could be critical in preventing prescription drug abuse.”

Audits director Kip Memmott, who noted that his younger brother has dealt with addiction for years, bluntly assessed Oregon’s efforts to monitor the prescription of opioids.

“Oregon has one of the weakest statutory frameworks in the country,” Memmott said at a press conference announcing his team’s findings.

For her part, Fagan recalled how her mother suffered an opioid overdose in 2009 and nearly died from it. She acknowledged the OHA’s explanation that making the PDMP more effective requires a number of legislative fixes but was in no mood for that excuse. Noting that the 2018 audit had won a national award and spurred other states to fix their own PDMPs, Fagan expressed frustration that OHA had fully implemented only a third of the earlier recommendations.

“That’s not good enough,” Fagan said. “It’s just not.”