Pubdate: Sun, 13 Apr 2008
Source: Sarasota Herald-Tribune (FL)
Copyright: 2008 Sarasota Herald-Tribune
Contact:  http://www.heraldtribune.com/
Details: http://www.mapinc.org/media/398
Author: Thomas Tryon

AN ONLINE RX FOR DRUGS' DEADLY TOLL

Suppose a doctor who teaches and practices pain medicine asked you to
support legislation that would help save lives, improve patient care,
prevent addictions and stem illegal trafficking in prescription drugs.

Suppose that a local pharmacist wrote you a letter stating, "The
amount of dubious prescriptions for oxycodone, methadone, fentanyl,
other miscellaneous opiates and benzodiazepines that enter my pharmacy
is not only frightening, it's appalling."

Suppose that your state's medical examiners issued a report warning
that the number of deaths linked to abuse of powerful painkillers and
sedatives has steadily increased in your region and state -- exceeding
the death toll from some of the most widely used illegal drugs.

And suppose that medical research in the United States showed that
electronic recording and tightly controlled sharing of patients'
medication histories promoted patient safety.

Now, stop supposing. All these things have happened.

I was recently paid an office visit by Dr. Rafael V. Miguel. He's
director of the pain medicine program at the University of South
Florida. He practices at a Sarasota Memorial Health Care System clinic
and is certified by the American Board of Anesthesiology, with a
subspecialty in pain medicine.

An expert, in other words.

Dr. Miguel and the Florida Society of Anesthesiologists support Senate
Bill 1550, which calls for the creation of a statewide "Patients'
Medication History Web Site."

The bill would empower the state Agency for Health Care Administration
to help design and operate a Web site that "gives health care
practitioners, pharmacies, and pharmacists access to patient
medication history through a privacy-protected" electronic record.

The Web site, if used properly, would provide protection against
multiple prescriptions that might pose contraindications or other
risks. It would link doctors and pharmacists, and enable them to flag
suspicious patterns associated with attempted purchases of
high-powered narcotics.

Miguel said the site would give reputable docs more confidence: In
other words, they'd know if their patients are getting drugs elsewhere
- -- and either selling or abusing them. He concedes that the site
wouldn't prevent doctors who run "pill mills" -- dispensing meds
without regard to patient need, often at big profits -- but stressed
that it would help pharmacists question suspicious
prescriptions.

Pharmacists already know there's a problem, according to Dan Gregory
of Sarasota, who wrote a letter to the editor in February, expressing
his professional concerns about the rising number of "dubious
prescriptions" and the resulting threats to public health.
"Intervention would definitely reduce needless overdoses and deaths,"
he wrote.

The numbers and trends are troubling. In 2006, the Florida medical
examiners' report said, 160 people died from drug overdose in
Sarasota, Charlotte, Manatee and DeSoto counties -- nearly triple the
number five years prior. During the first six months of 2007, 101
deaths in Sarasota, Manatee and DeSoto counties were directly caused
by six of the most abused drugs.

Medicaid and private-sector insurance programs patient-data Web sites
to control costs and monitor treatments. Dr. Miguel says states that
use similar sites have lower drug-related death rates than those that
don't use the technology.

So, suppose you were in the Florida Legislature: If you had all this
information, would you let SB 1550 languish in the Senate Judiciary
Committee or allow its companion to stall in the House Committee on
Health Quality, as they're doing? Or would you demand that this
legislation not be allowed to die because, if it does, more Floridians
will unnecessarily do the same?
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MAP posted-by: Derek