June 27. 2009 14:21

For several years now, the fastest growing drug problem in this country has been the diversion and abuse of prescription drugs. It is now the second largest type of drug abuse, accounting for approximately a third of all drug abuse, and its numbers are still growing. Currently, by the Department of Health's own statistics, as many as 9 people daily die of prescription drug abuse just in the state of Florida.
Only an effective prescription drug monitoring program has a chance to curb the meteoric rise of this scourge. The program in all the 38 states which already have a prescription drug monitoring program share at least one characteristic in common, they have continued to see this problem rise. Even in the state of Kentucky which implemented their "model" program in 1999, they have seen a continuing rapid rise in morbidity and mortality due to the problem. In Oregon, which is one of the states that has not had a program during this time, there has actually been a slight decrease in the numbers of prescription drug abuse ad the problems resulting.
There are a number of factors contributing to this lack of effectiveness of these programs in preventing prescription drug abuse and its catastrophic sequelae. Only a few of these reasons may be more to do with today's culture and not directly a result of any drug monitoring programs. A significant reason for the continuing and growing problem is how these programs are structured.
The biggest problem is that the data collection and analysis is not real time. It may be a month or more (if ever) before an inappropriately prescribed and dispensed drug will show up on the state-run prescription drug monitoring database. In other words, even if the program works, it doesn't help until drug diversion has already been committed by the individual at least once. Even then, the next time that individual tries to fill an inappropriate prescription, the pharmacist must raise the suspicion, then take the time to log onto the system and see if that individual has already been reported. And if that individual is using a fraudulent ID, the system is not going to identify that patient as a doctor shopper or drug abuser.
There was an alternate bill pending in the Florida State Legislature this year. It promoted a very effective program that is already up and running very successfully on a limited basis in South Florida. It uses unalterable biometric scans and a live link and functions anonymously so that a name, social security number, date of birth or any other identifying information is never transmitted and stored. This system can instantly identify almost all cases of improper prescriptions presented to the pharmacy instantaneously. It not only can but does stop prescription diversion on a daily basis at the point where the diversion occurs, at the pharmacy counter. If the system is used in a physician’s office, the problem can be curtailed before a prescription is ever written.
Despite a herculean effort on the part of Carl Domino to pass this bill, it was defeated primarily due to the House and Senate leadership effectively precluding the bill from an honest and open debate. Rather, a bill of dated and ineffective technology was passed. Florida's legislators had the chance to take the leadership in this country in this vital and critical effort to curb drug abuse. But instead, the legislators elected to become just another "me-too" state and take the 39th place among states pursuing a largely ineffective system. I imagine their thinking was just "to do something" ... anything, in order to try and convince constituents they are fighting this problem. But they have provided the good side in the drug wars with largely ineffective and certainly outdated weaponry.
We can only hope that Governor Crist has the leadership and the foresight to turn this back to the legislators and demand an effective and up to date technology system to combat this scourge. Florida's citizens certainly deserve better than what they got! And if the majority of Florida’s legislators don’t have the vision and leadership it takes, we should have confidence that our Governor does.

LH