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State senators endorse drug database to pinpoint abuse by doctors, patients

By Mark Hollis
Tallahassee Bureau
Posted January 7 2004

TALLAHASSEE · A statewide computer database to help investigators determine who is illegally using, prescribing and handing out narcotic painkillers and other drugs appears likely to win approval this spring after years of legislative debate.

Stymied before by concerns over privacy and funding, the computerized system was unanimously endorsed Tuesday by a state Senate health care panel and is expected to clear the Republican-run Florida House.

The goal of the system would be to cut down on so-called "doctor shopping," in which patients visit several physicians to obtain drugs, either to feed their addiction or to sell on the street.

In 2002, there were 9,116 drug overdoses in Florida. Thirty-six percent of those deaths involved prescription medicines. Prescription drug abuse accounts for an average of five overdose deaths a day in the state, exceeding deaths from illegal drugs such as cocaine or heroine.

"This system will save lives. Law enforcement and state officials would be able to track more closely any patterns of abuse," said state Sen. Mike Fasano, the New Port Richey Republican sponsoring the Senate version of the legislation and a companion measure that exempts much of the data from ordinary public records access. The proposals are contained in Senate Bills 578 and 580.

Under the proposal, backed by Gov. Jeb Bush, a doctor would be required to submit data to the Florida Department of Health concerning a patient and the patient's prescription.

When the order is filled, the pharmacist would also send an electronic record of the order to the department.

If the doctor or pharmacist accessed the confidential, Internet-based database and noticed anything peculiar about the prescriptions, they could contact law enforcement or state health officers.

Investigators could look at the information only if they had an active investigation under way. Unauthorized use of the database would be a third-degree felony, subject to up to five years in jail and fines up to $5,000.

Currently, law enforcement has access to the information, but not in an organized database.

The system would track more than 100 commonly prescribed medications, including every prescription written by doctors, filled by patients and dispensed by pharmacists. The information would be held for two years.

James McDonough, director of the governor's office of drug control, has said the database is necessary to give police and health professionals a warning that drug abuse and dealing may be going on under a doctor-patient relationship. Such fraud and abuse was first tracked in a 2002 South Florida Sun-Sentinel series "Rx for Death."

The newspaper reports highlighted the problems of addiction and overdose deaths in Florida tied to, among other drugs, the painkiller Oxycontin. As a result of the news accounts, Purdue Pharma, the maker of Oxycontin, pledged $2 million toward software for the program in exchange for the state dropping an investigation into how the company marketed the painkiller.

Legislators are still wrangling over how to pay ongoing costs of running the system, which Fasano said may exceed $1 million a year.

The legislation urges -- but doesn't require -- the system be designed to allow "real-time" access to the data. In such a system, a patient's drug history could be retrieved while the patient is still in the examining room or waiting at the pharmacy. At least 15 other states have put some prescription monitoring system in place, but most take significant time, sometimes weeks, before a doctor or pharmacist can learn of a patient's drug use history.

House Speaker Johnnie Byrd and other Republican legislators worried about lack of medical privacy are pressing for limits on the system.

As a result, the legislation says the database will be destroyed in two years if the Legislature doesn't renew it.

Also, it exempts reporting drug history information for children under 16 and for hospitals, nursing homes and other care centers where drugs are distributed.

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