TAMPA — Less than two weeks before the launch of the state's much-anticipated prescription drug monitoring program, pharmacists and others are scrambling to get ready to meet the requirements of the law — some more than others.
At major pharmacy chains such as CVS, much of the work is happening behind the scenes, in large information technology departments. But at smaller, independent operations, pharmacists are using words like "chaos" and "pain in the neck" to describe how things are going.
"The anxiety I have is not having this set up until a day or two before it's mandated," said Dan Fucarino, owner of Carrollwood Pharmacy.
On Sept. 1, Fucarino will be among thousands of medical practitioners who will be required to report information about the controlled substances they dispense into a statewide database. They'll have to report who received the drug, how much they received, how they paid for it and who prescribed it, among other things. The database is intended to help doctors spot the drug abusers, and help law enforcement officers catch them.
Much is riding on its success. Lawmakers, doctors and police see the database as a key tool in the state's fight against a prescription drug abuse epidemic that kills an average of seven people a day, and is getting worse. Data released last week showed a 9 percent increase in prescription drug deaths from 2009 to 2010.
"It will save lives," said state Sen. Mike Fasano, R-New Port Richey, who pushed for the database for years before lawmakers passed the law in 2009 creating one.
But even Fasano recognizes the challenges of getting the ambitious database off the ground.
"I'm cautiously optimistic," he said. "Until the database is in force, we'll hold off on celebrating."
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In recent years, Florida lawmakers have passed a number of bills aimed at ending the state's reputation as the "Pill Mill Capital of the U.S."
Chief among them is the 2009 law creating the prescription drug monitoring database. Florida is among only a handful of states that has no way to track the prescribing, selling and buying of such drugs as oxycodone and Xanax. That has made the state a popular destination for people looking to obtain large quantities of the drugs so they could either resell them for large profits, consume them to feed their addictions, or both.
The law requires most medical practitioners who dispense any of more than 100 controlled substances to enter information into a statewide database. The list includes pain medications such as oxycodone and hydrocodone, but also anabolic steroids and weight-loss drugs. Failure to do so will be considered a first-degree misdemeanor.
Those who administer the medications in certain settings, including hospitals, nursing homes and Department of Corrections facilities are among those who do not have to report to the database.
Pharmacists this month began to register to use the database, which has been named E-FORCSE, for Electronic-Florida Online Reporting of Controlled Substances Evaluation.
At CVS, computer staffers are developing a system in which the required information will be automatically transmitted to the state, said Mike DeAngelis, a CVS spokesman.
But for smaller operations, the task can be more daunting.
"We don't have an IT department; we are the IT department," said Dr. Illan Suarez, who owns Idel Pharmacy in Tampa.
Suarez said small pharmacies have to work with software vendors to get the information to the database. He expects a certain level of "confusion and chaos" during the first few months.
Fucarino pointed out that not being able to register for the database until Aug. 1 gave him only 30 days to get a system in place. "Usually, just testing the software takes months," he said.
The law doesn't provide pharmacists any money, though Fucarino says he expects minimal, if any, additional costs. He's using his existing software vendor to set up his reporting system.
There also is the issue of time. Reporting information to the database can add to pharmacists' already busy schedules.
"I'm sure that it will take more time," Suarez said. "And if it takes me more time to fill these prescriptions, patients are the ones that are going to be affected. It might take longer to get medicines. I just don't have all the information yet."
Adding to the possible demands on pharmacists' time, the law also requests that they submit by Nov. 1 information about drugs they dispensed from Dec. 1, 2010, to Aug. 31, 2011. That, however, is not a requirement, said Rebecca Poston, program manager for the database.
Beginning Oct. 17, medical practitioners will be able to look up information on the database.
Law enforcement officers can request information from the database that pertains to active investigations. But they will not be allowed to access the database directly to look for abusers, a provision in the law meant to address patient privacy.
Many warn the database isn't a silver bullet. Some point to its flaws: Pharmacists have seven days to report information to the database, which law enforcement officers have said is enough time for someone to visit multiple pharmacies and receive large quantities of drugs. And while pharmacists are required to report the information, they and other medical practitioners aren't required to check the database before writing a prescription or dispensing a drug.
Others point to the power of addiction. "A very motivated individual will find a way to overcome all obstacles," Suarez said. "I don't think it will have a significant impact."
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Capt. Robert Alfonso, a supervisor in the narcotics division with the Pinellas County Sheriff's Office, disagrees.
He said of the recent laws passed to aid in the fight against prescription drug abuse, the monitoring database will make the biggest difference.
"Drug abuse and doctor shopping will go down," he said.
Fucarino said the database is long overdue.
"As much as it is a pain in the neck now, and as much as I know the first months will be difficult, this is something that should have been implemented two or three years ago," he said.
"I think the pill mills will close within six months. Florida will not be the destination for the entire southeastern U.S. to get oxycodone."
Richard Martin can be reached at firstname.lastname@example.org or (813) 226-3322