[HARMRED] fyi: States linking prescription databases, fight abuse

Tue Oct 19 11:52:11 CDT 2010

Food for thought in terms of structural interventions for preventing
prescription drug overdoses... 

Atlanta Journal-Constitution

http://www.ajc.com/news/nation-world/states-linking-prescription-databas
es-682928.html 

Friday, October 15, 2010 

States linking prescription databases, fight abuse

By EMERY P. DALESIO 

The Associated Press 

RALEIGH, N.C. - Starting next year, dozens of states will begin knitting
together databases to watch prescription drug abuse, from powerful
painkillers to diet <http://g.ajc.com/r/C8/>  pills.

With federal money and prodding, states are being asked to sign onto an
agreement allowing police, pharmacies and physicians to check suspicious
prescription pill patterns from Nevada to North Carolina.

Civil liberties and privacy advocates have objected to the state
databases, which would be linked with technology and standards developed
by the Justice and Homeland Security departments.

Thirty-four states operate databases to fight a drug problem authorities
say is growing more deadly than heroin.

"I've got people that are kin to me that's addicted and I see firsthand
what it does," said Tracy Carter, sheriff in Lee County, N.C.. about 30
miles southwest of Raleigh. "The thing that's so darn frustrating is our
young people don't think it's that big of a deal. 'It's a pill. It won't
hurt me. The doctor prescribed it.' But it's worse than crack cocaine."

North Carolina had 826 unintentional deaths due to controlled substances
last year, said Bill Bronson, the state health official in charge of the
database. In comparison, there were 482 homicides statewide.

Nationally, there were 27,658 overdose deaths from prescription
medication in 2007 - more than heroin and cocaine combined, the Centers
for Disease Control and Prevention reported in July. The threat is
increasing as the most addictive pain relievers including OxyContin,
which can produce a euphoric feeling, become more common, the Drug
Enforcement Administration said.

Penney Cowan, founder of the American Chronic Pain Association, said she
understands the need for monitoring potential abuse. But she worries the
databases will discourage people who legitimately need painkillers.
Physicians already are spooked by the fear their legitimate prescribing
may trigger interest from investigators, she said.

"What we never hear about is how people with pain, who because they take
these medications, are able to function, to be a productive part of
society," Cowan said.

The databases alert physicians and pharmacies to patients who see
several doctors to collect multiple prescriptions, letting them judge
whether to refuse a potential abuser. Law officers say the databases
allows them to document a pattern of abuse after investigations or
informants point to a suspected pill dealer or dirty doctor.

A 2006 report conducted for the Justice Department said prescription
drug databases cut the supply of painkillers and stimulants, reducing
the probability of their abuse. The rate of painkiller abuse would have
been 10 percent higher by 2003 without the databases, the report said.

The Prescription Monitoring Program Information Exchange would swap
information through a central hub at Ohio's Board of Pharmacy. State
databases were checked more than two million times in 2008, the Justice
Department said. The databases flagged prescription activity on nearly
500,000 more potential abusers.

A proposed interstate compact will be unveiled in time for legislatures
to consider it when they assemble next year, said John Mountjoy, policy
and research director of the Council of State Governments, a national
nonprofit based in Lexington, Ky.

The contract would preserve state-by-state differences that include
control of the databases by law enforcement agencies in Texas and
California, health departments in North Carolina and Alabama, and
pharmacy boards in more than a dozen states.

Doctors are encouraged to check the databases, but in 19 states the law
says they aren't required to do so, according to the National Alliance
for Model State Drug Laws.

There are also differing limits on law officers' access. Some states
require investigators to get a warrant or court order, while others just
require an active investigation on a suspect. Vermont doesn't allow law
officers to access the database.

Some privacy groups are worried about hackers and identity theft after
millions of electronic records were stolen from Virginia's database last
year.

North Carolina radio talk shows and bloggers erupted in September when
sheriffs proposed changing state law to give them easier access to the
database. A common complaint was that investigators could invade their
privacy, though most didn't know sheriff's deputies have been able to
query the database since 2007.

"The problem is the public doesn't know about this database," said Daren
Bakst, legal and regulatory studies director of the conservative John
Locke Foundation in Raleigh. "You have access to a database of so many
innocent individuals in order to find a tiny percentage who may be
abusing."

___

October 15, 2010 09:28 AM EDT 

Rachel McLean, MPH

Adult Viral Hepatitis Prevention Coordinator

STD Control Branch

California Department of Public Health

Phone: (510) 620-3403

Email: Rachel.McLean at cdph.ca.gov

Website: www.cdph.ca.gov/programs/pages/ovhp.aspx 

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