Prescription for effectiveness
Cindy Harney of Sarasota visits the gravesite of her son, Garrett, who died of a prescription drug overdose in 2006. He was 20 years old. Cindy Harney was instrumental in pushing the Legislature to create a prescription drug database.
Recently, we called upon the governor and Legislature to approve new funding for Florida's prescription drug database, by which the medical community and law enforcement can monitor the sale of powerful painkillers and other controlled substances.
Last week we learned that funding -- though vital -- is not enough: Florida's year-old database program needs teeth.
An investigative report by the Tampa Bay Times, published Sunday, revealed that only 8 percent of Florida physicians have ever checked the database before prescribing the painkiller oxycodone and other powerful -- and too often deadly -- drugs.
Pharmacists who fill those prescriptions are even less likely to check the database, the Times reported.
"Who would be opposed to this?" Cindy Harney of Sarasota asked a Times reporter. Harney, whose 20-year-old son Garrett died of a prescription drug overdose in 2006, went to Tallahassee to fight for creation of the drug database.
"Who would ever be opposed to saving a life?"
The reason for the failure of most of doctors and pharmacists appears to be simple: Nothing in the law requires them to check.
The law governing the database has only one requirement: Dispensers of the drugs, usually pharmacists, must enter the prescription's details into the state's online program within seven days.
Amend the law
We would like to think that physicians and pharmacists entrusted with caring for the sick would voluntarily take the time -- estimated at a minute or less -- to check a database designed to prevent drug abuse and deaths from overdose. After all, prescription drug abuse kills an average of more than six people a day in Florida.
Obviously, such concern must be mandated. We urge the Legislature to amend the database law to require doctors and pharmacists to consult the database before writing or filling prescriptions for the specified controlled substances.
Given the lack of participation in the program, it's amazing that Florida has begun to stem the tide of prescription drug abuse.
Two years ago, lack of a prescription drug database in Florida and other lax laws encouraged the growth of illicit pain clinics. Drug dealers and abusers swarmed into the state to make high-volume purchases.
Florida became known as America's "pill mill capital."
Creation of the database and other steps taken by Florida in the past year to regulate pain clinics are finally helping to clean up the state's image.
In January, the federal Drug Enforcement Administration announced that:
• Sales of oxycodone, one of the most abused prescription drugs, fell 20 percent from 2010 to 2011.
• Florida doctors bought 97 percent less oxycodone last year than in 2010.
• In 2010, 90 of the top oxycodone-buying physicians were in Florida. Last year, that number dropped to 13.
Just imagine how successful Florida's efforts would be if more than one doctor in 12 were using the database.
Kentucky's example offers some insight.
After years of voluntary use of Kentucky's prescription drug database, the Times reported, "just one in five prescribers were using the system." The system processed about 2,900 requests a week.
Last year, Kentucky mandated participation. Now the system gets 95,000 weekly inquiries.
Every state except Missouri has a drug database or laws requiring the creation of one. Twelve states have approved mandates.
Florida should be the next.
But first, the Legislature needs to ensure the future of Florida's drug database.
Unreasonable restrictions on the funding of the database -- denying not only state dollars but contributions from pharmaceutical companies -- were written into the legislation to appease Gov. Rick Scott and others who initially opposed the bill. Financial support was limited to grants and donations.
Those limited funds are on the verge of drying up. The state officials who operate the database have only enough money to last through next June.
Ideally, the Legislature would provide annual funding for this critical program,which costs about $500,000 a year. At a minimum, it should remove the restriction on funding by drug companies.
Purdue Pharma, the maker of the OxyContin brand of oxycodone, has offered to contribute $1 million toward funding the Florida database. That money alone would fund the database two years.
That at least would give the state time to figure out a more suitable way to preserve this worthwhile program.
Need is clear
Also, while ensuring, at a minimum, interim funding for the database, the Legislature should change the law to require participation by all physicians who prescribe federally controlled medications and all pharmacists who fill those prescriptions.
The painkillers and sedatives tracked by the database are invaluable to patients who need them; those patients' access should not be unnecessarily impeded. But the need to maintain the database, mandate participation and provide strict penalties for noncompliance is clear.
If legislators need additional motivation to strengthen the database program, they should talk to Cindy Harney.
"It's not going to save my boy," she told the Times. "But think of all the others it could save."
http://www.heraldtribune.com/article/20121015/OPINION/310159995?p=1&tc=pg
