NarxCare drug addiction assessment system

NarxCare is an algorithm used across several US states to track prescriptions for drugs such as opioids and purports to identify and flag patients with ‘drug-shopping’ behaviours - people purportedly prone to narcotic, sedative and stimulant abuse, and who might be lying to doctors about the pain they’re in in order to get opioids.

Developed by Bamboo Health (formerly named Appriss), NarxCare combs through the multi-state Prescription Drug Monitoring Program (PDMP) database, and uses machine learning to generate an "Overdose Risk Score" from 000-999 that potentially includes emergency medical services and criminal justice data. The score is available to pharmacists, doctors, and hospitals.

The algorithm takes into consideration factors including: the number of doctors that have prescribed the medication to the person, the amount of medication they’re taking, the number of pharmacies the person goes to fill out their prescription, and other factors such as overlapping prescriptions and medication deemed likely to worsen or increase the risk of abuse or misuse.

Risks and harms 🛑

Narxcare scores have been criticised by researchers and patient advocates for their lack of transparency, as well as the potential for the unfair treatment of women and minority groups.

Incidents 🔥

• NarxCare drug addiction assessment system wrongly denies patients opioids

Research, advocacy 🧮

• Oliva J.D. Prescription-Drug Policing: The Right To Health Information Privacy Pre- and Post-Carpenter

• Oliva J.D. Dosing Discrimination: Regulating PDMP Risk Scores

• Siegel Z. In a World of Stigma and Bias, Can a Computer Algorithm Really Predict Overdose Risk?

• Cochran G. et al. Validation and threshold identification of a prescription drug monitoring program clinical opioid risk metric with the WHO alcohol, smoking, and substance involvement screening test