Doctor-shoppers and others who obtain prescription drugs by fraud should fear the PMP.
Those who get multiple prescriptions for narcotics from different doctors or forge prescriptions may fly under the radar of narcotics investigators for a while. But officials say it's a matter of time before the prescriptions come back to haunt them.
PMP is Mississippi's Prescription Drug Monitoring Program, evolving as a clearinghouse for prescription medication records since 2005. The PMP is an ever-growing database used to pinpoint drug seekers, prescription-drug dealers and even unscrupulous health-care professionals.
Program officials say the PMP has 12,000 registered users and about 3,000 inquiries are run on an average day.
PMP and law enforcement officials point to a key concern on why the PMP is important: 90 percent of overdose deaths in Mississippi in 2012 were from prescription drugs and most of the deaths were accidental, according to the Mississippi State Department of Health.
Professional regulations require pharmacies, nurse practitioners and doctors with DEA licenses to register with the PMP, but only pharmacies are required by law to input data into the computer system.
How it works
Pharmacists or their designated users are required to access PMP every 24 hours and enter data on prescriptions, said Dana Crenshaw, program director. It takes about 1.2 seconds for a registered user to access the latest available information on prescriptions associated with a person's name, she said.
Health-care users can access the database if they're suspicious about patients or customers. Narcotics investigators are allowed to check a name only if the person is targeted in an active criminal investigation.
"You can't just go in willy-nilly and check on people," Crenshaw said. "There's a $50,000 fine for misuse of the PMP."
Doctors can check new patients and those who appear to be drug seekers with no apparent medical need for a controlled substance.
The PMP can show doctors and pharmacists if a person appears to be doctor shopping, or trying to obtain narcotics from a doctor by deceit. A red flag would be a person who has received the same or similar controlled substances from other doctors in a short time frame and has filled the prescriptions at different pharmacies.
The PMP also can access a person's prescription data from all neighboring states except Alabama.
Things that make you go 'huh?'
Gulfport Pharmacist Larry Knox said he uses the PMP whenever he becomes suspicious.
"Sometimes there's just little things that raise red flags," Knox said.
"It's probably more of a value for doctors to look at the PMP, but it becomes my responsibility when something seems strange."
Knox owns and operates Beach Pharmacy. He knows his regular customers.
"Strangers coming in sometimes make me wonder," he said. "It's also people wanting to get a prescription a week early, or a stranger coming in with a prescription from a pain-management clinic in Louisiana.
"It's things that make me go 'huh?'"
Knox said he calls the prescribing physician when the PMP tells him a person is receiving the same narcotics from different doctors.
But then a federal privacy law known as HIPAA kicks in, he said.
"I call the prescribing doctor and say, 'You might want to look at this person's PMP,'" Knox said, "Because of the federal government's privacy rule, you don't tell the doctor what you see. You don't talk about it and you don't print out the PMP."
Pharmacists were the first to begin using the PMP after the state Legislature set it up to operate under the Mississippi Board of Pharmacy.
Related professions are coming on board, Crenshaw said. For instance, the state Medical Board of Licensure adopted a regulation that, as of 2014, requires those who prescribe, administer or dispense controlled substances to register with PMP.
How effective is PMP?
PMP isn't as effective as it could be because it doesn't include all prescriptions written, Harrison County Sheriff Troy Peterson said. He said he has used the PMP for several years.
"PMP is a very helpful tool for law enforcement, but it can be a hindrance because it's not state-mandated for all service providers to use it," he said.
"I know that all of the providers don't use PMP."
Doctors, he said, have told him they don't have the money to hire a person to put data in the system.
Peterson said his investigators look up reports daily on people who abuse pharmaceuticals. He said his office gets a lot of calls from pharmacists.
Biloxi Police Chief John Miller said his department calls the Mississippi Bureau of Narcotics when it wants to check on a person. MBN is the only law enforcement agency with "unfettered access" to the PMP, program officials said.
Detective Sgt. Aldon Helmert said Biloxi's narcotics agents receive a lot of calls from doctors and pharmacists and tips from residents.
"Usually, by the time we get a call about a bad doctor or pharmacist, we already know the name," Helmert said.
Combined efforts of local, state and federal agents have led to recent prison convictions in pill-mill and pill-ring cases.
Peggy Laporte of Metairie was operating a Waveland health clinic described as an out-of-control pain-management clinic. She was sentenced Thursday after pleading guilty. A prosecutor said Laporte learned how to run a pill mill while working for a woman who went to prison for the same crime.
Dr. Sanjay Sinha of Woodstock, Ga., operated what a prosecutor called a "roving pill mill" and built his "cash-only" clientele through casino visits in Harrison County. He was sentenced in October.
Court records show an Ocean Springs pharmacist had alerted authorities that one of Sinha's patients had suspicious prescriptions.
In 2010, Biloxi pharmacist Nick Tran went to prison in a pill-mill case along with husband-and-wife doctors who ran a medical clinic next door to his business.
MBN Director Sam Owens describes the PMP as "the pre-eminent investigative tool" for catching those who violate prescription-drug laws. He said the database is growing and prescription-drug violators will turn up sooner or later.
"Once their names come up, it's already done," Owens said. "The proof is there."
No routine reports
Some states allow their PMPs to run routine reports to find people who obtain multiple controlled substances from multiple doctors.
Mississippi's PMP doesn't do that, said Steve Parker, deputy director of the pharmacy board.
"We recognize there are legitimate uses of controlled substances and many citizens who need these drugs," he said. "Cancer patients who are going through horrible circumstances, for instance, and many others see several doctors.
"What we're trying to focus on is the illegal use of prescription drugs. If you put a program in place where a system is looking for red flags, our fear is it's going to put a red flag on someone because of their circumstances."
"We've seen tremendous growth," he said. "Pharmacists have believed in this since its beginning and are committed to its growth."
Parker said the pharmacy board and the PMP administrator are working to educate related professionals on how they can be a part of the solution.
"Prescription-drug abuse is a scourge on our society and we are trying to do everything we can to stop it," Parker said.