“I’m not expecting that there should ever be a one-to-one query (per prescription),” Orr said.

“At our current rate, which is 8.9 percent queries for the total, we compare to the states that have no mandates,” he said. The states with the strongest mandates have query rates of about 40 percent, Orr said.

“We have a mandatory use law, but the way it’s written currently nobody knows where they really fall into it,” he said. “We hope to remove that confusion and get the utilization up higher.”

Proposed legislation would require prescribers to query the prescription monitoring program when writing a new prescription and then at least every 90 days for prescriptions with refills.

Many prescribers were not even registered to use the program until the state began automatically registering them last year. With the mandatory registration, the program now has 70,000 users, up from 26,371 last July, just before the automatic registrations began.

“Where the problem comes in, is there is no enforcement for doctors who don’t query the program database before writing a prescription,” said Timothy S. Musselman, a doctor of pharmacy and executive director of the Virginia Pharmacists Association.