Maine Program Distributes Drug Arrest Records to Doctors and Pharmacists

A program in Maine is helping to combat prescription drug abuse by providing a monthly list of people arrested or summoned for prescription or illegal drug-related crimes to doctors and pharmacists.

The program, Diversion Alert, is helping doctors and pharmacists identify patients at risk of overdosing, in need of addiction treatment or engaged in illegal prescription drug distribution, says Executive Director Clare Desrosiers.

She discussed the program at the recent Rx Drug Abuse Summit in Atlanta.

In addition to alerting doctors and pharmacists about patients with possible abuse and addiction problems, Diversion Alert also provides tip sheets to help them respond to these patients.

The program was established in Aroostook County, Maine in 2009, and was expanded statewide in 2013, with a two-year grant from the state’s Attorney General’s office.

The grant funding will soon run out, Desrosiers said. A bill to fund the program with state money will be considered this session by the state legislature. Desrosiers has applied for several grants, and has also started raising money through a crowdfunding site, diversionalert.causevox.com/.

In addition to receiving monthly reports, subscribers to Diversion Alert also gain access to an online, searchable, password-protected drug charge database, which contains an 11-month record of substance abuse-related arrests in Maine. Booking photos are provided when available.

A pre/post study with comparison groups conducted in 2013-2014 found that prescribers who participated in Diversion Alert became more aware of the prescription drug abuse and diversion problem in their area, communicated more with health care providers about shared patients, stopped prescribing controlled substances to patients selling their prescription, and reported improved attentiveness to prescribing for all patients. Fifty-two percent of Maine health care providers participating in the post-survey evaluation reported that they found at least one patient listed on a Diversion Alert report in the past 12 months.

Diversion Alert is different from Maine’s Prescription Monitoring Program, which is administered by Maine’s Department of Health and Human Services. That program provides doctors and pharmacists with information about all controlled substance prescriptions dispensed to patients in Maine. It uses a separate online, password-protected database. The prescription monitoring program automatically notifies prescribers when a patient engages in behaviors that could indicate misuse, such as visiting a large number of doctors and pharmacists in a short period. It does not alert prescribers when a patient has been charged with trying to buy or sell prescription drugs.

“Ideally, doctors should be looking at both databases,” Desrosiers said. “The data in the prescription monitoring database in many cases doesn’t overlap with Diversion Alert data.”

One 2014 study of Diversion Alert found that the majority of people arrested for trafficking prescription drugs are not “doctor shopping” or “pharmacy hopping.” The study found that of 295 people listed in Diversion Alert for drug trafficking charges, 76 percent were not listed in the state’s prescription drug monitoring database. “It’s complementary, not duplicative,” Desrosiers notes.

Currently about 24 percent of the state’s actively licensed prescribers and pharmacists are registered with Diversion Alert, according to Desrosiers. “It doesn’t cost much and it has very good outcomes,” she said. “We found 59 percent of doctors said they used Diversion Alert to intervene with patients they find listed in Diversion Alert reports. That’s what we want to happen.”

Doctors who find a patient has been charged with prescription or illegal drug-related crimes are advised to stop prescribing controlled substances to that patient, and to consider referral to a detox center or medication-assisted treatment for patients coming off a high dose of opiates. Doctors are also advised to offer alternatives for pain, anxiety or ADHD treatment, such as non-steroidal anti-inflammatory drugs and other non-opioid medications; physical therapy, chiropractic, massage and other alternative therapies; and behavioral treatment, such as medical yoga, and cognitive behavioral therapy.