Pubdate: Fri, 17 Aug 2007 Source: Daytona Beach News-Journal (FL) Copyright: 2007 News-Journal Corporation Contact: http://www.news-journalonline.com/ Details: http://www.mapinc.org/media/700 Note: gives priority to local writers Bookmark: http://www.mapinc.org/find?232 (Chronic Pain) PAIN PATROL Drug Database Could Hurt Patients Once again Florida is under pressure to build a database of people who take powerful opiate painkillers. The rationale behind the database: Identify doctors who are writing fraudulent prescriptions and single out patients who are going from office to office "doctor shopping" for drugs to sell or get high with. Federal authorities blasted Florida this week, claiming the state is becoming a haven for black-market dealers and users. They cited statistics: For example, sales of codeine, morphine, oxycodone, hydrocodone and meperidine -- the most commonly abused painkillers -- increased by 90 percent from 1997 through 2005 The number sounds intimidating. But it doesn't necessarily point to widespread abuse. For starters, Florida's over-65 population -- most likely to be in need of strong pain medication -- increased more than 12 percent over that time span. Drug companies have been more aggressive about marketing their wares, and a growing emphasis on palliative care for terminally ill patients, and pain relief for all, has also contributed to an increased use of painkillers. Without rummaging through each patient's medical records, it's impossible to say whether the increased rate of prescriptions is warranted -- or a sign of trouble. But that hasn't stopped 30 other states from taking action. Florida shouldn't be too hasty to follow suit. As implemented in those states, prescription-drug databases can be draconian, influencing doctors to stop writing as many prescriptions for pain medication -- a practice that might curb abuse but also leaves many patients suffering. Meanwhile, patients in those states are turning to the Internet or illegal importation schemes to meet their needs -- just as those who seek to abuse pain medication are doing. And there's little evidence that Florida is having a tough time catching offenders. In some cases, prosecutors have clearly been overzealous. Richard Paey, a Pasco County man convicted of illegally obtaining oxycodone and other pain medications, is now serving a 25-year sentence -- despite overwhelming evidence that Paey suffered from chronic, excruciating pain and never intended to sell or abuse the medication. Second District Court of Appeals Judge James Seals wrote of Paey's case that he got a higher sentence from possessing 100 pills than he would have gotten for robbing a pharmacist at knifepoint and stealing 50. Writing in the dissent, Seals proclaimed the sentence "unusual, illogical and unjust." Paey's sentence was upheld, and supporters are pleading with Gov. Charlie Crist for clemency. While he considers this case and others like it, Crist and lawmakers should also ask themselves whether they're ready to deal with a flood of similar stories -- the likely result of an intrusive database combined with over-tough possession laws. The last time Florida lawmakers considered a database law, they included several measures that would have made it less intrusive, including a requirement that patient data be purged after two years. State officials should also consider patient protection measures like a hotline for patients who think they've been unfairly denied pain medication, and close monitoring to ensure that physicians aren't turning away people who are in genuine agony. But the best move is to resist federal pressure to institute a database, understanding that such a measure is likely to do more harm than good. - --- MAP posted-by: Beth Wehrman