COUNTY CRACKDOWN ON DRUG ABUSE

Pressed by a community increasingly affected by prescription drug
abuse, Sarasota County commissioners responded Tuesday with a new,
strict set of regulations.

The rules are designed to preserve access to legitimate
pain-management practitioners but keep out illicit businesses --
those that feed a black-market trade in addictive narcotics.

The county's new requirements represent a step forward -- if they
withstand potential legal challenges and can be properly enforced. The
community also should recognize that crackdowns alone cannot solve the
growing problem of opiate addiction. Prevention and educational
efforts, as well as broader treatment options, are needed.

The county's new measures affect only medical establishments defined
as "pain management clinics." (Among the criteria, the clinic must be
one that issues more than 20 prescriptions a day for controlled
substances or is advertised as being in the business of pain
treatment. Surgery centers and hospitals are not included.)

To acquire and keep their county operating license, pain-management
clinics will have to follow a stringent code. The doctor in charge
will have to swear that the clinic will operate in accordance with all
applicable county and state laws as well as state administrative
rules. Clinics that fail to live up to these sworn statements can lose
their license and face perjury charges.

Going Beyond State Law

Most prominently, the new rules require a pain-clinic physician to
check a statewide drug monitoring database for each patient, before
writing him or her a prescription for a controlled substance. The
doctor must document this review by keeping a printout in the
patient's file. (Privacy rights must be protected.)

The required database check helps assure that a patient isn't "doctor
shopping" to serve an addiction or the illicit drug trade.

The county's rule goes beyond that of a new Florida law, which calls
for pharmacies to update a statewide drug monitoring database after
filling a prescription for a controlled substance.

The state's database isn't expected to be implemented until this fall.
Whether Sarasota County could enforce its requirement in the meantime
is not clear.

In general, the county's pain-clinic regimen builds on recently
approved state standards that toughen rules and requirements for
operating these centers.

The county's new ordinances appear to be more comprehensive, however,
than the recently signed state law, which exempts certain pain
management specialists.

Strict Requirements

Other aspects of the county's measures include requirements that
pain-management clinics submit to certain inspections; not be "cash
only" operations; close by 7 p.m. weekdays; maintain precise personnel
records; keep a tally of prescriptions broken down by drug and age
group; and other details.

The clinics (and to some extent their landlords) must ensure that no
loitering, unlawful conduct or alcohol consumption occurs on the
property or neighboring areas. These provisions present enforcement
challenges.

Under new zoning rules also approved this week, the clinics cannot be
on the same property as a pharmacy. They also are required have
adequate parking, a waiting area and restrooms.

Clearly, the regulatory requirements are onerous, but that's the
point: The rules are supposed to discourage shady, irresponsible
operators from setting up shop in the county.

Still allowed -- and necessary -- are establishments that
responsibly serve patients' genuine medical pain-control needs.

In Florida, an average of seven deaths a day are linked to
prescription drugs such as methadone, the painkiller oxycodone, and
the sedative alprazolam. In many cases, autopsies find the presence of
multiple drugs and alcohol, a combination that can lethally suppress
the cardiopulmonary system.

Tuesday's public hearing included wrenching testimony from local
mothers whose teenage children fell down the black hole of
prescription drug addiction. These experiences, along with other data
including a reported 86 percent increase in narcotic-addicted
newborns, show that prescription drug abuse is not just a crime. It is
a tragedy that cannot be allowed to proliferate.