Prescription Drug Monitoring Program Update

Attached links to several interesting articles regarding the so-called "pill mill database:

* A Sun Sentinel Editorial entitled “ Opposition to pill mill data base dissolves” http://www.sun-sentinel.com/news/opinion/editorials/fl-pill-mills-editorial-dl-20110417,0,5137083.story correctly points out that the latest change to HB 7095 includes support for a prescription drug monitoring program and restores tough regulations on pain management clinics that House leaders had threatened to strip from the bill. Thew new bill is far from perfect! Small pharmacies complain that the new version puts them at a disadvantage to the larger big-box drug chains where most medications are prescribed. More importantly, people who need these medications may find the bill creates new hurdles to getting them. Lawmakers should take the greatest care to make sure that that is not the case.
* Another article published in today's Sun Sentinel “ Why, and how, South Florida pill mills must be shut down” http://www.sun-sentinel.com/news/outlook/fl-nscol-pill-mills-prosecute-sanadi-20110417,0,5970691.story written by Nabil El Sanadi,MD points out that the newly formed pill mill" Multilateral Task Force should mandate that: That said, the task force should mandate that:
* The Board of Medicine exercise its power on licensees — physicians — to register as pain management specialists and to monitor each prescriber's activity to ensure compliance with 64B 9.013.
* The prescription drug database should be used to track doctor-shoppers and to detect over-prescribers, so that the attorney general, local law enforcement and the DEA can get these criminals off the streets.
* Physicians should be mandated to report suspected doctor-shopping and possible drug diversion, just like we have to report child abuse and certain communicable diseases.
* Physicians and pharmacists should be required to use the database when prescribing or dispensing narcotics.

I am concerned that mandated reporting and the required use of the database may trigger significant political backlash from physician organizations and Republican legislators. I suggest focusing instead on allocating funds to educate physician on how to use the database and on how to identify doctor-shoppers. Subsequently, physicians will recognize that the exclusion of doctor-shoppers is good business.
* An additional article published in today's Sun Sentinel “ New Database Blocks Sales of Cold Medications” http://articles.sun-sentinel.com/2011-04-16/health/fl-cold-medicine-database-20110416_1_meth-labs-ephedrine-products-pain-pill-database highlights the success of the National Precursor Log Exchange database which went live in January, and through late March, has blocked more than 40,000 illegal ephedrine sales in Florida. lorida joined 11 states last year in passing legislation that forces pharmacies to track ephedrine products in a database. "It has been among the most successful laws we've had in reducing meth production," said Jim Hall, director of the Center for the Study and Prevention of Substance Abuse at Nova Southeastern University in Fort Lauderdale.The system has been compared to the pain-pill monitoring system that's been under fire in Tallahassee, which aims to crack down on pain-pill trafficking across Florida. Both systems track consumer information to show patterns of abuse, and both aim to stop people from doctor shopping or pharmacy hopping. Police and sheriff's associations pushed for the ephedrine database after reporting an alarming number of meth lab explosions in North Florida in 2009. Several people, including a baby, were severely burned. The rising popularity of the "shake and bake" meth-making method is largely to blame, authorities said. People have discovered how to make the narcotic in a 2-liter soda bottle, which builds with pressure and often erupts into flames. Although meth labs are more prevalent in North and Central Florida, a surprising number of blocked ephedrine sales in South Florida indicates that "smurfers" have been driving south to stock up, Beasley said. A smurfer is an individual who find and/or gather the raw materials for their dealer to make more drugs.FDLE launched the database as a pilot program in 2008 in North Florida. In one year, law enforcement agencies reported that it contributed to 133 arrests. The system flags people who try repeatedly to buy ephedrine over the legal limit, and police use those leads to open drug investigations. Investigators with the South Florida High Intensity Drug Trafficking Area use it to help local police find possible "smurfers." They look through the system for suspicious activity and alert respective agencies.

Yours
Bernd