PAIN AND PUNISHMENT

Drug Database Could Work Against Patients

The news out of South Florida is certainly scary -- illicit "pill
mills" providing prescriptions of potent painkillers to addicts and
dealers, combined with soaring death rates from legal narcotics.

The Legislature's predictable response: Pass a law meant to curb
prescription drug abuse through a statewide database that tracks
doctors who prescribe controlled drugs, and patients who are issued
such prescriptions. Lawmakers didn't fund the database, and it won't
be operational until late next year.

That's time enough to reconsider the breadth of the net the state is
casting. Deaths from recreational prescription-drug abuse are
generally limited to one of a handful of powerful pain medications
such as oxycodone, sold under brand names including OxyContin, and
hydrocodone, also known as Vicodin or Lortab. Yet the state would
record prescriptions for hundreds of drugs, including Ambien (a
commonly prescribed sleep aid) and medications prescribed for
attention-deficit disorder. And it would keep the information --
including the name, address and birth date of patients -- on file for
up to two years.

The legislation, signed last week by Gov. Charlie Crist, would
probably have provided more useful information by targeting
prescription drugs associated with known trafficking patterns and high
levels of abuse, and giving Florida health officials a quick-response
law allowing them to target the bogus "pain clinics" in Broward and
Miami-Dade counties that are luring drug dealers from across the nation.

Florida's new law includes some important protections. It doesn't
track prescriptions for hospice or nursing-home patients, and it
doesn't include prescriptions for children under 16.

But the Legislature should consider testimony from other states that
have had databases in place for years. Those accounts suggest doctors
are more reluctant to prescribe pain medication, even to patients who
need it, when database laws are in place. Florida officials should add
a hotline for patients who believe they have been denied pain
medication unfairly.

"Once doctors know that there is a . . . database of controlled
substances prescriptions that overzealous law enforcement will be
scrutinizing to harass doctors, there may be no doctors left who are
willing to treat chronic pain," said U.S. Rep. Ron Paul, R-Texas,
arguing in 2004 against a nationwide drug database.

That should be a serious concern for Florida lawmakers, who represent
a population that includes a large proportion of seniors -- who are,
in turn, more likely to need pain relief and palliative care.

The growing number of illicit prescriptions flowing from South Florida
provides a genuine source of statewide concern. But the Legislature's
solution shouldn't cause more pain than it relieves.