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Thursday, Jun 21, 2018
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Don't kill Florida's pill database

The state needs all the help it can get in battling prescription drug abuse. Controlled substances contribute to thousands of deaths in Florida each year. Yet a promising tool the state employs to combat the epidemic - the Prescription Drug Monitoring Program - continues to be criticized as an invasion of privacy that should be abolished or regulated into impotence. That would be a mistake. Although the program has yet to fulfill its promise, it has great potential to reduce prescription drug abuse and root out fraud at minimal cost. Under the program, pharmacies and other dispensers of controlled substances are required to report the names of the patients receiving the drugs, the drug type and quantity and the prescribing physician into a database that can be accessed by doctors and law enforcement. Doctors can check to see whether someone seeking a controlled substance is getting the same drugs from other doctors. Law enforcement can check for fraud when investigating complaints.
In fact, a successful use of the database by law enforcement is what unleashed the latest criticism. While investigating a fraud complaint, drug agents obtained a list of 3,300 patients seen by four doctors. The investigation resulted in several arrests. Although most of the 3,300 patients had nothing to do with the fraud, the entire list was given to defense attorneys as part of the legal process. Despite warnings that the list is not a public record, one of the attorneys notified a fellow attorney who was among the patients on the list. That attorney sued, claiming the state should not have released the records of patients who had nothing to do with the fraud. The American Civil Liberties Union is asking for a federal investigation. Whether the state should have released the names of every patient on the list is a legitimate question. And the outcry has led to a review by the state Department of Health into the security of the database. The agency is considering tighter controls on access. The tweaks should make for a more secure handling of the records. Considering the database has been operational for less than two years, it is far too early to consider this one breach to be a fatal flaw. Keep in mind that the attorney was wrong to ignore the confidentiality warnings and alert the other attorney. Forty-one other states have similar databases up and running, according to the state's Department of Health. Some states allow law enforcement to access the database directly, while others require some level of judicial review before granting access. In Florida, law enforcement must file a report as part of an active investigation before the state grants access. That seems reasonable, but we'll wait for the conclusion of the Department of Health's review before passing judgment on access, or whether the state should redact the names of innocent patients before releasing confidential lists to attorneys involved in court cases. Across the state, there are positive signs that the battle against prescription drug abuse is succeeding. The number of pill mills has declined markedly as local and state agencies crack down, and the number of deaths attributed to prescription drugs is dropping, from 2,710 in 2010 to 2,539 in 2011, a 6.3 percent decrease. How much the database is contributing toward those declines can't be quantified. But the declines coincide with an uptick in the database's usage by doctors, who can now log on to a computer to learn whether the patient in the waiting room has a history of shopping around for prescription drugs and might be a dealer looking to score. Denying that prescription before it ever gets filled is the most effective deterrent there is.
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