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.
