The Prescription Drug Monitoring Program (PDMP) database should be periodically monitored in a chronic pain patient receiving opioids.
Indications for checking the database:
(1) when starting a patient on opioids
(2) when writing a new prescription for an opioid
(3) if opioid misuse is suspected
(4) every 3 months if none of the above apply
Red flags from the database:
(1) getting opioids and/or benzodiazepines from more than 1 pharmacy
(2) getting opioids and/or benzodiazepines from more than 1 provider
(3) receipt of a controlled substance that has not been reported
If the PDMP is state-specific, then sometimes it can be useful to check databases in adjacent states.
