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A Times Editorial

Better controls on prescription drugs desperately needed

The records of nearly 200 doctors accused of peddling prescription drugs illustrate how intractable this drug epidemic is in Florida. Unscrupulous pain clinics have garnered headlines for out-of-state and home-grown addicts who line up outside their doors. But an analysis by St. Petersburg Times reporters Letitia Stein and Susan Taylor Martin shows that greedy or irresponsible doctors from all specialities have helped fuel this addiction. Regulators and law enforcement sorely lack the coordination and authority to battle it. Legislators need to provide more tools to combat this scourge, which kills an average of seven Floridians a day.

The old war on drugs was simpler. Cocaine, heroin and other street narcotics were illegal, no matter where they were sold. Now suppliers can hide behind white coats, prescription pads and a medical license. Even a well-meaning physician can be duped by doctor shoppers, addicts or dealers who visit several doctors to collect multiple prescriptions.

The Republican-led Legislature recently took action, albeit grudgingly. Lawmakers finally agreed in 2009 to join other states that have created prescription drug databases to track recipients of drugs classified as Schedule II through IV, which include oxycodone, amphetamines, Vicodin and Xanax. But the database is delayed due to a bid protest, and the law has major loopholes: Doctors aren't required to check it before prescribing drugs and there's a 15-day lag in entering data.

Lawmakers also approved new regulations this year requiring pain clinics to register, submit to annual inspections and eventually follow the state's clinical guidelines. Starting today, they must be owned by a licensed Florida doctor. But several counties — including Hillsborough, Pasco and Pinellas — have enacted their own regulations. Pinellas extended its moratorium this week and banned new clinics from opening for two years.

But county-by-county enforcement isn't ideal. What's needed is a statewide, coordinated effort by law enforcement and medical leaders to develop new mechanisms to attack a problem that is destroying lives and families across socioeconomic lines.

Such efforts must recognize that prescription drugs enable thousands of Floridians to live productive lives despite extraordinary physical pain. Doctors — not government — are the best qualified to ascertain a patient's drug regimen. And doctors shouldn't be held accountable when a patient ignores medical advice and overdoses.

But better controls are desperately needed. For starters, regulators — including doctors' groups — need to work together to propose fair laws that would make it faster and easier to strip licenses from bad doctors rather than counting on the criminal justice system to weed them out. Medical examiners should be required to report overdose deaths to the health department, along with the doctor's name found on prescription bottles at the death. And law enforcement should be required to report to regulators any physician arrested in connection with prescription drugs.

Such efforts will inevitably bring more scrutiny on even honest doctors whose only goal is helping patients racked with pain. But the medical community shares responsibility to help weed out corrupt colleagues. Combatting this epidemic requires cooperation on all fronts.

Better controls on prescription drugs desperately needed 09/30/10 [Last modified: Thursday, September 30, 2010 4:59pm]
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