The Michigan Department of Licensing and Regulatory Affairs says the number of opioids dispensed in the state decreased by 15% in 2018 compared with the year before. The number of prescriptions dispensed fell from roughly 9.6 million in 2017 to about 8.2 million in 2018.
The data provided by LARA show that the individual units dispensed (such as tablets and milliliters) decreased by 16.9%, the total days’ supply of opioids decreased by 10.8%, and the "milligram morphine equivalent," or the standard used to measure the potency of opioids, decreased by 21%.
LARA says that over the same timeframe, enrollment in the Michigan Automated Prescription System by pharmacists, subscribers, and other health care professionals more than doubled, from about 29,000 to more than 68,000.
MAPS is the state’s drug monitoring program, set up through LARA. Originally created in 2003, it allows for the state and medical professionals to track controlled substances and schedule 2-5 drugs (which includes many opiates) to be tracked in a larger system. MAPS serves as a clinical and regulatory system with two main functions. The first is to provide clinicians with a better understanding of the drugs they were prescribing and to help them assess the risks of prescribing drugs on a patient by patient basis. The second is to identify clinicians and prescribers who may have been over-prescribing or over-dispensing to patients who may not need the drugs in question.
Kim Gaedeke is the chief deputy director for LARA. She says MAPS is primarily to help health care providers protect the health and safety of their patients, and could be partially responsible for the decrease in opioid prescriptions.
“The goal isn't to cut off the supply completely or to limit access for patients to get the necessary treatment, whether that be to be prescribed an opiate or controlled substance,” Gaedeke says. “At the end of the day, it's all about finding that balance so that patients aren't put at risk because of the prescribing behavior of a clinician who is disregarding that risk.”
She adds that LARA is very sensitive to the privacy of the data MAPS stores.
“You have a state entity monitoring these types of drugs that are being dispensed to patients… our role is to protect the health, safety, and welfare of the public.”
Michigan law requires all clinicians who prescribe and dispense schedule 2-5 controlled substances to check MAPS for a patient's prescription history before they prescribe such a substance in a quantity that exceeds a three-day supply.