Anyone who has experienced chronic pain and needed opiates for relief--and been turned down--or had roadblocks placed in their way..should read this..it's long..but chock full of information:
www.wired.com
A small excerpt:
In the hospital, doctors performed an ultrasound to rule out some worst-case scenarios, then admitted Kathryn for observation to monitor whether her ovary was starting to develop another cyst. In the meantime, they said, they would provide her with intravenous opioid medication until the crisis passed.
On her fourth day in the hospital, however, something changed. A staffer brusquely informed Kathryn that she would no longer be receiving any kind of opioid. “I don’t think you are aware of how high some scores are in your chart,” the woman said. “Considering the prescriptions you’re on, it’s quite obvious that you need help that is not pain-related.”
Kathryn, who spoke to WIRED on condition that we use only her middle name to protect her privacy, was bewildered. What kind of help was the woman referring to? Which prescriptions, exactly? Before she could grasp what was happening, she was summarily discharged from the hospital, still very much in pain.
Back at home, about two weeks later, Kathryn received a letter from her gynecologist’s office stating that her doctor was “terminating” their relationship. Once again, she was mystified. But this message at least offered some explanation: It said she was being cut off because of “a report from the NarxCare database.”
Like most people, Kathryn had never heard of NarxCare, so she looked it up—and discovered a set of databases and algorithms that have come to play an increasingly central role in the United States’ response to its overdose crisis.
Over the past two decades, the US Department of Justice has poured hundreds of millions of dollars into developing and maintaining state-level prescription drug databases—electronic registries that track scripts for certain controlled substances in real time, giving authorities a set of eyes onto the pharmaceutical market. Every US state, save one, now has one of these prescription drug monitoring programs, or PDMPs. And the last holdout, Missouri, is just about to join the rest.
In the past few years, through a series of acquisitions and government contracts, a single company called Appriss has come to dominate the management of these state prescription databases. While the registries themselves are somewhat balkanized—each one governed by its own quirks, requirements, and parameters—Appriss has helped to make them interoperable, merging them into something like a seamless, national prescription drug registry. It has also gone well beyond merely collecting and retrieving records, developing machine-learning algorithms to generate “data insights” and indicating that it taps into huge reservoirs of data outside state drug registries to arrive at them.
NarxCare—the system that inspired Kathryn’s gynecologist to part ways with her—is Appriss’ flagship product for doctors, pharmacies, and hospitals: an “analytics tool and care management platform” that purports to instantly and automatically identify a patient’s risk of misusing opioids.
On the most basic level, when a doctor queries NarxCare about someone like Kathryn, the software mines state registries for red flags indicating that she has engaged in “drug shopping” behavior: It notes the number of pharmacies a patient has visited, the distances she’s traveled to receive health care, and the combinations of prescriptions she receives.
Eventually she came upon an explanation that helped her understand where she’d gone wrong: She had sick pets.
The Pain Was Unbearable. So Why Did Doctors Turn Her Away?
A sweeping drug addiction risk algorithm has become central to how the US handles the opioid crisis. It may only be making the crisis worse.
A small excerpt:
In the hospital, doctors performed an ultrasound to rule out some worst-case scenarios, then admitted Kathryn for observation to monitor whether her ovary was starting to develop another cyst. In the meantime, they said, they would provide her with intravenous opioid medication until the crisis passed.
On her fourth day in the hospital, however, something changed. A staffer brusquely informed Kathryn that she would no longer be receiving any kind of opioid. “I don’t think you are aware of how high some scores are in your chart,” the woman said. “Considering the prescriptions you’re on, it’s quite obvious that you need help that is not pain-related.”
Kathryn, who spoke to WIRED on condition that we use only her middle name to protect her privacy, was bewildered. What kind of help was the woman referring to? Which prescriptions, exactly? Before she could grasp what was happening, she was summarily discharged from the hospital, still very much in pain.
Back at home, about two weeks later, Kathryn received a letter from her gynecologist’s office stating that her doctor was “terminating” their relationship. Once again, she was mystified. But this message at least offered some explanation: It said she was being cut off because of “a report from the NarxCare database.”
Like most people, Kathryn had never heard of NarxCare, so she looked it up—and discovered a set of databases and algorithms that have come to play an increasingly central role in the United States’ response to its overdose crisis.
Over the past two decades, the US Department of Justice has poured hundreds of millions of dollars into developing and maintaining state-level prescription drug databases—electronic registries that track scripts for certain controlled substances in real time, giving authorities a set of eyes onto the pharmaceutical market. Every US state, save one, now has one of these prescription drug monitoring programs, or PDMPs. And the last holdout, Missouri, is just about to join the rest.
In the past few years, through a series of acquisitions and government contracts, a single company called Appriss has come to dominate the management of these state prescription databases. While the registries themselves are somewhat balkanized—each one governed by its own quirks, requirements, and parameters—Appriss has helped to make them interoperable, merging them into something like a seamless, national prescription drug registry. It has also gone well beyond merely collecting and retrieving records, developing machine-learning algorithms to generate “data insights” and indicating that it taps into huge reservoirs of data outside state drug registries to arrive at them.
NarxCare—the system that inspired Kathryn’s gynecologist to part ways with her—is Appriss’ flagship product for doctors, pharmacies, and hospitals: an “analytics tool and care management platform” that purports to instantly and automatically identify a patient’s risk of misusing opioids.
On the most basic level, when a doctor queries NarxCare about someone like Kathryn, the software mines state registries for red flags indicating that she has engaged in “drug shopping” behavior: It notes the number of pharmacies a patient has visited, the distances she’s traveled to receive health care, and the combinations of prescriptions she receives.
Eventually she came upon an explanation that helped her understand where she’d gone wrong: She had sick pets.
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