How The Opioid Crisis Turned Pharmacists Into Cops

Three changes created this shift: Overdose deaths became a national crisis. Law enforcement agents grew more effective at targeting physicians and pharmacists they thought were over-providing opioids. And legislatures and pharmacies pressured pharmacists to use prescription drug monitoring programs, known as P.D.M.P.s, big data systems funded in part by the U.S. Department of Justice.

P.D.M.P.s are surveillance technologies initially created for law enforcement. They generally compile personally identifiable information about all controlled substances (not just opioids) dispensed to patients in a state and feed it back to law enforcement and health care providers. Law enforcement uses P.D.M.P.s to track physicians, pharmacists and patients, and health care providers use them to track medications patients receive. P.D.M.P.s lack privacy protections applied to other health care data.

Use of P.D.M.P.s changed pharmacists’ routines and relationships by incorporating surveillance into patient interactions. When pharmacists refuse to dispense opioids to patients who need them or call the police on patients, they route them toward illegal drug supplies or into law enforcement territory. The result: people with substance use disorders are dying at alarming rates, and some patients with untreated chronic pain are turning to suicide. Pharmacists protect themselves from becoming law enforcement’s targets, but they put their patients in harm’s way.

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