Sunday, February 27, 2011;
PRESCRIPTION MEDICATIONS are the fastest-growing drugs of abuse in the United States, as a huge federal-state operation in Florida last week dramatically illustrated. Law enforcement broke up dozens of "pill mills" in which doctors allegedly issued phony prescriptions for highly addictive painkillers such as oxycodone, in return for cash - a lot of cash: Agents seized more than $2.2 million and 70 vehicles.
Turns out that Florida medical practitioners bought 41.3 million oxycodone pills in the first half of 2010, almost 10 times more than their counterparts in all 49 other states combined. There is simply no legitimate explanation for that.
Modern opioid pain relievers, a multibillion-dollar-a-year business, are blessedly effective for many suffering patients - but also highly addictive. Oxycodone, marketed as OxyContin, is known as "hillbilly heroin" for its devastating impact on Appalachia. Of course, the relief it legitimately provides to patients does not make headlines. Nevertheless, the damage is real, and the cost may be measured not only in lives but also in expenditures on law enforcement and medical treatment.
Thirty-five states, including Virginia, and the District have found a way to manage the trade-off: prescription drug monitoring programs (PDMPs), paid for with both their own funds and federal grants. PDMPs generally require doctors and pharmacies to report dispensing of controlled substances to a central database, where the information is kept securely, available only to authorized persons - such as doctors and pharmacists - with a need to know if patients have a history of "doc-shopping." Studies by both the Government Accountability Office and a Justice Department-funded consulting firm have found that PDMPs deter overprescription and reduce the probability of drug abuse.
Florida, not surprisingly, lags in this respect. In 2009, the state established a PDMP to be funded only through private donations; it has not yet gone into operation. Newly elected Gov. Rick Scott (R) wants to repeal even that weak measure, calling it an invasion of privacy. Perhaps more surprising, Maryland has done less than Florida has. This is especially troubling given that medical practitioners in Maryland purchased 423,000 oxycodone pills in the first half of 2010, more than those of all but three states, including Florida, according to Drug Enforcement Administration (DEA) statistics. That is eight pills for every 100 residents, 10 times the rate of California and 53 times the rate of New York.
In 2006, after Maryland's attorney general at the time, J. Joseph Curran Jr. (D), published a report detailing prescription drug abuse in the state, the General Assembly passed legislation establishing a PDMP. Then-Gov. Robert L. Ehrlich Jr. (R) vetoed it, expressing concerns that the bill could inhibit legitimate pain management and give the DEA unfettered access to records. Mr. Ehrlich called for an advisory council to study the matter, which happened under legislation adopted after Martin O'Malley (D) became governor. The group's report, published in 2009, recommended establishment of a PDMP altered to address concerns such as those Mr. Ehrlich voiced. A bill died in committee last year; Mr. O'Malley backs a new effort this year. The legislature urgently needs to push it forward.