Florida needs better drug monitoring

A Times Editorial
Published March 3, 2008

The abuse of prescription painkillers has quietly reached epidemic proportions in Florida. In the Tampa Bay area, prescription drug overdoses kill more people than cocaine and heroin, and they are on the way to becoming the leading cause of accidental death. This is an escalating crisis that requires a multifaceted response, including reopening discussions about creating a more effective state monitoring system to crack down on doctor shopping.

An illuminating special report by Times staff writers Chris Tisch and Abbie VanSickle recently described the dramatic increase in the abuse of prescription painkillers. Last year alone, overdoses are estimated to have caused 2,000 deaths statewide, including 550 in the bay area. Families described the pain and loss of loved ones. Overwhelmed judges and police officers detailed the difficulty in tracking those who manipulate the health care system to obtain more painkillers than medically necessary - and catching the complicit pharmacies and doctors. Too many holes in the system make it too easy to forge prescriptions or collect multiple prescriptions for painkillers that can be abused or sold on the street.

This is not a problem that can be solved with a single solution. The campaign against abuse of prescribed painkillers has to be as visible as the one against illegal drugs. Doctors and pharmacies have to be more vigilant in the way they handle prescriptions for painkillers, and law enforcement has to be just as serious about investigating this form of drug abuse as others. Finally, legislators need to create a more effective monitoring system to discourage doctor shopping and prevent abusers from improperly obtaining multiple prescriptions for painkillers that can be filled at multiple pharmacies with little fear of detection.

This is not an easy issue. There are serious privacy concerns for patients who are suffering and have legitimate prescriptions for painkillers. Doctors should not fear writing proper prescriptions for patients who truly need pain relief, and they should come to see additional computerized monitoring as a tool to protect themselves against deception. Unless the abusers and their enablers can be more easily identified, it will only become harder for legitimate patients to get relief and for their doctors to avoid an unfair cloud of suspicion.

Prescription monitoring isn't new. Insurance companies do it. Some 35 other states do it, and Florida does it for Medicaid patients. A broader state law passed last year is ineffective because it doesn't require pharmacies with different owners to share information. Abusers with fake or multiple prescriptions for painkillers from different doctors just have to be smart enough to visit different chain drugstores in different locations.

The abuse of prescription painkillers is a public health crisis that has devastated families, strained law enforcement and undermined the credibility of law-abiding doctors and pharmacies. It requires a comprehensive response that includes a narrowly drawn prescription monitoring program which adequately protects privacy while providing another tool to save lives and catch the criminals.