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Prescription Drug Monitoring 101: Tips for Healthcare Providers

doctor sitting at desk and prescribing drug to patient

The Importance of Prescription Drug Monitoring

Opioid use disorder takes the lives of more than 100 Americans each day. Research shows that over 21% of opioids that are abused were obtained from a single doctor, while 53% came from a family member or friend for free. Additionally, almost 84% of those that came from a family member or friend were originally obtained from a single healthcare provider. This statistic highlights an important opportunity for healthcare providers to step in using prescription drug monitoring.

In 2019, over 70% of drug overdose deaths involved an opioid. DRUGSCAN has been working tirelessly to stop the progression of opioid misuse to substance use disorder through effective prescription monitoring. Prescription drug monitoring can help providers detect medication misuse as soon as it begins in their patients, allowing for early intervention to stop the progression of substance use disorder.

Finding effective pain management for patients with debilitating chronic pain is complex and multifaceted. Despite the risks of prescribing controlled substances, chronic opioid therapy is often the best course of treatment for some patients. Through prescription drug monitoring, providers can offer patients the therapy they need while limiting their risks for substance use disorders. 

The Challenges with Prescribing Controlled Substances

The majority of chronic opioid prescribing is done in the primary care setting. One study using prescription data from more than half of the nation’s pharmacies found that nearly 30% of prescription opioids came from a primary care physician. Despite how important it is, healthcare providers face many challenges when prescribing and monitoring controlled substances, including:

  • A lack of training – Primary care providers often haven’t received specialized training in pain management, opioid prescribing, detecting medication misuse, preventing substance use disorder, or understanding the risk factors associated with controlled substances.
  • Lack of time during appointmentsA 2021 survey found that the average primary care visit lasted 18 minutes. Research also shows that physicians manage an average of 3.05 concerns each visit, with over half of patients discussing more than three concerns per encounter with their physician. Because of the number of worries that need to be addressed during a primary care visit, there often isn’t enough time to adequately discuss controlled substance use.
  • Patients not complying – Some patients may not be willing to comply with prescription drug monitoring. Many patients may not understand the risks associated with prescription therapy, and providers may not be prepared to talk to patients about limiting these risks.

By being aware of these challenges, healthcare providers can begin to overcome them, ensuring better approaches to prescribing controlled substances and monitoring patients for signs of misuse.

Read Our Blog: How Opioid Misuse Develops into Substance Use Disorder

Tips for Healthcare Providers

How to Approach Staff about Prescription Drug Monitoring

The most important thing to remind staff about prescription monitoring for their patients is that they must take a therapeutic approach. Prescription monitoring is not done for punitive purposes, and staff need to understand that. There is significant stigma, even within the healthcare system, surrounding substance misuse and substance use disorders, so reminding staff how important monitoring is can help them take a more compassionate, therapeutic standpoint.

“The goal with prescription drug monitoring is early detection,” says DRUGSCAN Toxicology Director Gina Cooper. “With early detection comes early intervention, which leads to improved patient outcomes.”

How to Approach Patients about Prescription Drug Monitoring

How a provider approaches patients about prescription drug monitoring is very important. When prescribing a controlled substance to a patient, healthcare providers should ensure that the patient understands:

  1. Controlled substances carry certain risks
  2. You have a responsibility as a provider to monitor their use
  3. Prescription monitoring is performed for early detection and intervention
  4. Testing is completed in a comfortable, therapeutic environment

It is not uncommon for patients to push back on prescription drug monitoring. They may feel that testing isn’t necessary or cost may be a concern. Healthcare providers can help patients understand the importance of prescription monitoring by sharing facts about the risks of controlled substances, such as in a single year, 1.6 million people misused prescription pain medication for the first time. The reason for sharing this statistic is not to scare patients but to ensure that they are educated on the risks of their treatment and why early intervention against prescription misuse is so essential.

Explore Our Infographic: The Cascade of Opioid Misuse

Follow Best Practices for Prescription Monitoring

Prescription drug monitoring guidelines can vary by state. However, there are some general best practices to follow. These include:

  1. Patient Risk Assessment – A risk assessment can determine if a patient has risk factors that make them more likely to misuse medication. This should be done before prescribing controlled substances and routinely throughout their treatment.
  2. Controlled Substance Agreements – A controlled substance agreement is a document that sets expectations for the provider and patient, outlining the benefits and risks of their therapy with prescription medication.
  3. PDMP Checks – Prescription Drug Monitoring Program (PDMP) databases will show if and what controlled substances the patient may be receiving from another healthcare provider. This should be reviewed routinely throughout their treatment.
  4. Toxicology Screening – Toxicology testing can help determine if the patient is taking their medication as prescribed and detect misuse or additional drug use.
  5. Pill Counts – Pill counts can help ensure that patients are taking their medication as prescribed by showing the number of doses the patient has left compared to what they should have remaining based on their prescribed dose and regimen. 

Implementing these five best practices in a clinical setting can reduce liability while improving patient outcomes.

Consider a Prescription Drug Monitoring Partner

Following best practices for monitoring your patients can be time-consuming and overwhelming. Partnering with a toxicology lab can help ensure the safety of your patients being prescribed controlled substances by detecting misuse early. Toxicology testing can determine exactly what the patient is taking. Providers should pay close attention to results that show positive but not prescribed medications, positive for illicit drugs, or negative for prescribed medication.

When considering a prescription drug monitoring partner, there are some things to remember. When finding a trusted partner, it is important to ensure that they:

  • Can give providers the answers they need
  • Are upfront about patient costs
  • Are efficient with the type and frequency of testing
  • Offer on-site resources for physicians


At DRUGSCAN, we merge science with clinical care. Our decades of experience have allowed us to develop consistent best practices regarding toxicology testing, all while staying innovative and aware of new research and resources to share with providers. DRUGSCAN not only performs efficient toxicology testing but has the unique experience to help healthcare providers identify red flags that may indicate medication misuse so they can determine the best course of treatment.

At DRUGSCAN, we are dedicated to helping you monitor the health and safety of your patients through responsive toxicology testing. To partner with DRUGSCAN, contact us today.

Learn More About DRUGSCAN's Prescription Drug Monitoring

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