PRESCRIPTION POLICE

The Florida Constitution incorporates strong privacy protections into its
Declaration of Rights. Article I, Section 23 promises that "every natural
person has the right to be let alone and free from governmental intrusion
into the person's private life." Most people would put medical
prescriptions under these protections. Prescriptions are ordinarily highly
personal information, not for government's prying eyes. But that is not how
the governor sees it, nor apparently the Legislature.

Lawmakers have been moving along legislation, strongly supported by Gov.
Jeb Bush, that would create a massive computer database, tracking more than
100 commonly prescribed medications. If it passed, the government would
hold information on each Floridian's use of such well-known medications as
Valium, Xanax and the painkiller OxyContin. Does the state really need to
track that many?

Proponents say a database would be an effective means of curbing
prescription drug abuse. Comprehensive computer records would give doctors
and pharmacists a tool to determine whether patients are engaging in
"doctor-shopping" - getting multiple prescriptions for the same drugs from
different physicians. And law enforcement would have access to investigate
individuals under suspicion of dealing drugs or abusing them.

But our constitutional traditions cry out for caution whenever the
government comes to pry, however persuasive the reason. The public interest
must be urgent, there must be no other way of serving it, and the intrusion
of privacy must be to the least extent possible. The sponsors of the
legislation could meet those concerns by narrowing the list of medications
that would be tracked. Prescription drug abuse is a real problem, and
doctors who knowingly capitalize deserve to be punished.

Beyond the obvious privacy concerns, the bills, HB 397 and SB 580, worry
advocates in the fields of pain control and mental health. With
prescription data centralized, physicians might be frightened away from
treating mental illnesses and severe pain aggressively, because treatment
often requires large quantities of the drugs under scrutiny. An atmosphere
of fear already pervades the prescribing of OxyContin, which has become a
favorite club drug. Chronic pain patients tell horror stories of trying to
access sufficient quantities of the drug to ease their suffering.

Doctors and pharmacists are not police officers and should not be expected
to add "narcotics detective" to their job descriptions. Many doctors see a
high volume of patients every day and may not have the time to use the
database for each patient. James McDonough, the state's drug czar, says
doctors won't be required to use it. But what if an overdose occurs? Will
this create an implication of negligence on the part of the doctor? The
House version exempts practitioners from liability for failing to consult
the database. The Senate version currently does not.

The signs from Tallahassee are that this legislation is likely to pass this
year. The cost to implement and maintain the system is expected to be about
$2.8-million annually, although a drug company has agreed to defray most of
the initial year's expenditure. McDonough expects to receive ongoing
federal grants of more than $600,000 per year. Still, into the future, this
is a costly endeavor that risks abuse.