Thought Police Lurking In Your Medicine Cabinet

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Thought Police Lurking In Your Medicine Cabinet

 

 

 

by Brenda Pitts Bennett

January 02, 2003

 

Every month Nevada pharmacists transmit to the state the names of people who

have purchased painkillers and other potentially addictive drugs prescribed by

doctors -- and that information is available to law enforcement officials...

 

Every month Nevada pharmacists transmit to the state the names of people who

have purchased painkillers and other potentially addictive drugs prescribed by

doctors -- and that information is available to law enforcement officials.

Nevada is one of 17 states in which police are able to collect the information

under the auspices of a federal program that has pharmacists file regular

reports that include patients' names, the names of their prescriptions, the

amount of the medication they receive and the names of their doctors. The

states' programs fall under the national umbrella of the Prescription Drug

Monitoring Program.

Nevada authorities say their system is different from those of other states

where the information is routinely funneled to police agencies.

" This is not used as a law enforcement tool, " said Louis Ling, attorney for

Nevada's Prescription Controlled Substance Abuse Prevention Task Force.

That 15-member task force tracks everything from hard-core narcotics to

prescribed painkillers and anti-anxiety medication like the frequently

prescribed Xanax and Valium pills. It is composed of representatives from boards

that license doctors, veterinarians, dentists and pharmacists as well as

physicians who specialize in the treatment of addiction. One member is from the

Nevada Division of Investigations.

" Nevada is unique, " Ling said. " These people (who are suspected of abusing

prescription drugs) don't need to be arrested. They need to be treated. "

In Nevada, use by law enforcement of the prescription drug information is

limited, he said. The task force turns over the data to police only after it is

verified that they have an open investigation of the individual. That must be

verified, Ling said.

" That doesn't take very much, does it? " said Alan Lichtenstein, general counsel

for the American Civil Liberties Union of Nevada.

Civil libertarians around the nation have said they are troubled by what they

see as the " Big Brother " aspect of the reporting system and the way it breaches

doctor-patient confidentiality.

" We're talking about medical information that is supposed to be private and

giving law enforcement open access to that, " Lichtenstein said.

Ling said the Nevada task force is sensitive to those types of concerns.

" We are not snooping around in somebody's medicine chest, " he said.

There are fewer than 100 cases of police access a year, Ling said. And the

federal Drug Enforcement Administration cannot get Nevada's information about

prescription drug users unless the DEA is working with a Nevada law enforcement

agency, Ling said.

Susan Griffin of Reno didn't realize her children's Ritalin prescription records

are reviewed by state authorities and could be turned over to law enforcement,

but she said she's OK with it.

" It's a controlled drug, it should be monitored, " said Griffin, a volunteer with

Children and Adults with Attention Deficit Disorder.

" I'm not shocked that it happens. If the drugs are being abused it should be

monitored. "

People who are going to one or two doctors for prescriptions are not singled out

by the task force, no matter how many drugs they take, Ling said.

The computer that holds this confidential information for the task force is not

hooked up to any outside line, so there cannot be any unauthorized access, he

said.

The task force meets once or twice a year to decide how to use the data that the

state receives from about 2 million prescriptions a year. Ling said the primary

mission is to identify those who might be abusing controlled substances. A

doctor who is treating a patient can request from the task force all of the

prescriptions filled for that individual over the past six months or past year.

The task force gets about 10,000 of those requests a year.

Ling said this helps physicians determine the amounts and varieties of drugs the

individual is using and whether he or she is " doctor shopping " -- going to

various doctors to get prescriptions and filling them at numerous pharmacies.

" The doctors love this, " he said.

Lichtenstein said not all doctors love it, however. He said the system keeps

some doctors from providing enough pain relief to their patients.

" A lot of people with terminal cancer or patients that are dying in agony are

not getting the proper pain medication because doctors are frightened about

being investigated for being a drug pusher, " Lichtenstein said.

Lichtenstein cited a national study that last month gave hospitals in Nevada the

lowest possible grade because they offered few pain management services.

And in May 2000, the Nevada Board of Medical Examiners said a regulation was

needed to ensure that patients receive adequate drugs to ease persistent and

extreme pain and at the same time protect doctors from sanctions.

Ling, however, said the task force does not investigate doctors or druggists who

appear to be over-prescribing. But it does provide information to the

appropriate licensing board if such a board has started an investigation of a

doctor or pharmacist.

Dr. Warren Evins, president of the Clark County Medical Society, said many

physicians are supportive of the program.

" I think it's a good program and I use it frequently, " he said. " I think most

patients know that certain drugs are controlled substances and that the DEA

regulates it. All physicians are aware of it. I would think patients are aware

too but I'm not positive about that. "

Tricia Leland, a program director with the American Cancer Society of Southern

Nevada, said she believes the records that are under scrutiny are not those of

terminally ill patients.

" They are actually targeting people who are not ill and don't need the

medications; that's what they are trying to control, " Leland said. " I don't

think it pertains to cancer patients. "

The task force does look for profiles of people who are going to numerous

doctors for prescriptions and having their prescriptions filled at numerous

pharmacies to avoid detection. The records of such patients are sent to the

doctors and drugstores that are providing the drugs, Ling said. The task force

finds fewer than 1,000 of those cases a year, he said.

The goal in those cases is to get doctors or pharmacists to encourage those

patients to seek treatment for drug abuse. Ling said there have been many

success stories in which individuals reduced the amount of drugs they were

taking or kicked the habit altogether.

Typically, those drug abusers are not recreational users but people who have

suffered from intense pain, Ling said. Among the most commonly abused

prescription drugs are OxyContin, Vicodin, Lontab and Narco, which are

classified as Schedule III painkillers.

Federal law breaks lists a number of controlled drugs on five " schedules. " The

schedules set control guidelines and regulations as to how each of the listed

drugs can be prescribed, as well as other control measures.

According to the U.S. Department of Justice, more than 1.7 million controlled

substance prescriptions were filled in 1997, the first year of Nevada's

prescription tracking program. Of those, 761,043 were Schedule IV drugs such as

Xanax and Valium.

In 1997, 4,680 patients exceeded what experts considered to be normal amounts of

the prescriptions but only 38 cases were referred to the Nevada Department of

Investigations. In 1998, 5,412 patients exceeded the drug threshold, but only 28

were referred to the Nevada Department of Investigations.

 

 

 

 

 

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