PAIN PATROL

Drug Database Could Hurt Patients

Once again Florida is under pressure to build a database of people
who take powerful opiate painkillers. The rationale behind the
database: Identify doctors who are writing fraudulent prescriptions
and single out patients who are going from office to office "doctor
shopping" for drugs to sell or get high with.

Federal authorities blasted Florida this week, claiming the state is
becoming a haven for black-market dealers and users. They cited
statistics: For example, sales of codeine, morphine, oxycodone,
hydrocodone and meperidine -- the most commonly abused painkillers --
increased by 90 percent from 1997 through 2005

The number sounds intimidating. But it doesn't necessarily point to
widespread abuse. For starters, Florida's over-65 population -- most
likely to be in need of strong pain medication -- increased more than
12 percent over that time span. Drug companies have been more
aggressive about marketing their wares, and a growing emphasis on
palliative care for terminally ill patients, and pain relief for all,
has also contributed to an increased use of painkillers.

Without rummaging through each patient's medical records, it's
impossible to say whether the increased rate of prescriptions is
warranted -- or a sign of trouble. But that hasn't stopped 30 other
states from taking action. Florida shouldn't be too hasty to follow suit.

As implemented in those states, prescription-drug databases can be
draconian, influencing doctors to stop writing as many prescriptions
for pain medication -- a practice that might curb abuse but also
leaves many patients suffering. Meanwhile, patients in those states
are turning to the Internet or illegal importation schemes to meet
their needs -- just as those who seek to abuse pain medication are doing.

And there's little evidence that Florida is having a tough time
catching offenders. In some cases, prosecutors have clearly been
overzealous. Richard Paey, a Pasco County man convicted of illegally
obtaining oxycodone and other pain medications, is now serving a
25-year sentence -- despite overwhelming evidence that Paey suffered
from chronic, excruciating pain and never intended to sell or abuse
the medication. Second District Court of Appeals Judge James Seals
wrote of Paey's case that he got a higher sentence from possessing
100 pills than he would have gotten for robbing a pharmacist at
knifepoint and stealing 50. Writing in the dissent, Seals proclaimed
the sentence "unusual, illogical and unjust."

Paey's sentence was upheld, and supporters are pleading with Gov.
Charlie Crist for clemency. While he considers this case and others
like it, Crist and lawmakers should also ask themselves whether
they're ready to deal with a flood of similar stories -- the likely
result of an intrusive database combined with over-tough possession laws.

The last time Florida lawmakers considered a database law, they
included several measures that would have made it less intrusive,
including a requirement that patient data be purged after two years.
State officials should also consider patient protection measures like
a hotline for patients who think they've been unfairly denied pain
medication, and close monitoring to ensure that physicians aren't
turning away people who are in genuine agony.

But the best move is to resist federal pressure to institute a
database, understanding that such a measure is likely to do more harm than good.