Force MDs to use drugs database, mom urges
PharmaNet shows drug histories
Helen Jennens flips through two sets of documents — one for each son who fatally overdosed.
Letters she sent in both cases to the College of Physicians and Surgeons of British Columbia alleging the careless prescribing of potentially dangerous medications are neatly organized among responses from doctors.
Jennens says the deaths of her sons, Rian Leinweber in August 2011 and Tyler Leinweber in January 2016, could have been prevented if doctors had checked their drug histories on B.C.’s unique real-time database PharmaNet.
The provincewide network links pharmacies and hospitals to a central database that stores information on all dispensed prescriptions. The system is also available to physicians, but doctors say most do not use it.
Jennens, who lives in Kelowna, has asked the college to make use of PharmaNet mandatory for all doctors so the files of high-risk or drug-seeking patients are flagged.
“Both boys, I have no idea how they lived as long as they did, with the medications they were prescribed, the combinations they were prescribed,” Jennens says through tears.
Rian was 37 when he died, three years after a truck collided with his motorcycle, crushing his right leg from hip to toe, requiring multiple surgeries.
Jennens went to Rian’s home with a pot of chili and found him propped up on his bed with his computer on his lap. He’d stopped breathing from a combined overdose after being prescribed benzodiazepines, various drugs for insomnia and depression, and opioids for chronic pain while he awaited a second hip replacement.
Jennens says she had warned doctors Rian could become hooked on opioids because he’d endured a decade of addiction that included cocaine and crystal meth.
After Rian died, Jennens requested his PharmaNet records and questioned why he was prescribed such a wide range of medications including opioids.
“Why didn’t these people say enough? That was my whole issue with PharmaNet,” Jennens says. “It lets you know somebody’s got a drug history. He’s on this cocktail for three years and nobody is concerned about what may happen in terms of overdose?”
A big part of Jennens’ complaint with the College of Physicians and Surgeons focuses on mandating the use of PharmaNet, which she says could be optimized to protect patients. “That didn’t happen, and five years later, my second son died,” she says of Tyler, who had ruptured his left Achilles tendon in 2008 while playing football and was prescribed OxyContin.
He became addicted to heroin and unknowingly took what turned out be fentanyl in his exwife’s bathroom, where he was found dead on the floor. A coroner’s report says he had overdosed on the powerful opioid.
Armed with 173 pages of PharmaNet records listing Tyler’s medications, Jennens filed a second complaint and “pleaded” with the college to make the use of PharmaNet compulsory for all doctors.
Jennens’ first complaint to the college resulted in one doctor being directed to take two continuing medical education courses on the responsible prescribing of opioids and strategies to manage chronic pain through less reliance on drugs.
Her complaint after Tyler died was forwarded by the college to 20 doctors who were cited for their prescribing habits. In their response letters, some doctors say they did not access PharmaNet, while others say Tyler’s death prompted them to use it.
Dr. David Hawkins says in his letter that the medical system allowed Tyler’s family to suffer “as a result of his death, and that was quite possibly avoidable. Certainly his medical encounters did not present him with treatment that could have offered him a way out of his situation.”
In June 2016, as part of revised standards for prescribing drugs that could be misused, the college made the use of PharmaNet mandatory at walk-in and methadone clinics.
Dr. Heidi Oetter, the college’s registrar and CEO, says the prescription monitoring system was “best in class” compared with any other in Canada. However, she called PharmaNet “clunky” and says its ultimate success will require government officials to consult doctors “to really make it operational in their offices.”
“We’re committed to making access to PharmaNet mandatory once everybody can easily access the system,” Oetter says.