Pill Mills Special Report: New Database May Treat Florida's Prescription Drug Epidemic

Florida is moving forward with a database that could help treat Florida’s  epidemic.

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After two years of delays, the state got the green light last week to implement the Prescription Drug Monitoring Program, a tool that curbs “doctor shopping,” the practice in which someone gets multiple, duplicate prescriptions filled by multiple doctors or pharmacists. 

“I’m extremely pleased,” said , R-New Port Richey, who fought for the program for seven years before it was passed by then-Gov. Charlie Crist. “...There’s no reason that the PDMP should not move forward.”

The program, an online database, was stuck in limbo for two years because of budgetary concerns and a vendor dispute. And this year, new threats appeared in the form of an objection byGov. Rick Scott and a House bill that would repeal the program. 

It appears those threats have dissolved, however.

On Friday, April 8, the state Surgeon General, Dr. H. Frank Farmer announced the Department of Health has the go-ahead to implement the database. The go-ahead comes at the end of a 30-day waiting period instituted after an administrative judge ruled in favor of the Department of Health in its dispute with a vendor that lost its bid to be involved with monitoring the program.

The program tracks a person’s prescription history. It requires practitioners to report dispensedSchedule II-IV drugs to the state Department of Health database within 15 days of filling a prescription. The lower on the state’s controlled substance schedule the drugs are, the higher the risk of abuse. Schedule III drugs include Oxycodone and Hydrocodone, two highly addictive drugs in Florida. Schedule IV drugs include some Anabolic steroids, Codeine, Ketamine, Hydrocodone with Aspirin and Hydrocodone with Acetaminophen.

Doctors, pharmacists, police, patients and others can access the database to see a patient’s prescription history. Doctors and pharmacists can do it while a patient is visiting his or her office.

Scott had called on the Legislature to repeal the program. It’s an “invasion of privacy” he had told the press.

“The governor’s stance hasn’t changed,” said Lane Wright, the governor’s new press secretary, last week. “He does not support the prescription drug monitoring program, but he does support addressing the pill mill problem.”  

In March, Scott said he wanted the state to reject a $1 million donation from Purdue Pharma, the manufacturer of OxyContin, to the PDMP Foundation, a private nonprofit that raises money for the program. The Foundation has collected $500,000 for the database and secured another $800,000 in federal grant pledges. When the program was created, the state pledged to use only private and federal money to fund the database.

On March 30, Scott announced he was using $800,000 to form a strike force of local law enforcement agencies and state departments to tackle drug crime. The strike force includes Hillsborough County Sheriff David Gee and St. Petersburg Police Chief Chuck Harmon. The force concentrates on prescription and illicit drugs.

“That strike force goes to the root of the problem” by teaming up local police with state reinforcement, Wright said. 

The House leadership had backed Scott’s stance on the PDMP, and had plans to enforce it. State Rep. Robert Schenck, R-Spring Hill, filed a bill repealing the PDMP (HB 7097).

He proposed another, revised bill (HB 7095) repealing state regulations of pain management clinics and banning doctors from dispensing Schedule II or III drugs. It also only allows pharmacies with $100 million in taxable assets or at least 10 years of being licensed in the state to dispense Schedule II or III prescription drugs.  HB 7095 is slated to be heard by the House Appropriations Committee today

Schenck did not return requests for comment.

In the days before the state got the go-ahead to move forward with the program, Fasano said Schenck’s bill puts small pharmacies at a disadvantage and risks putting them out of business. He said he was against Schenck’s proposal to repeal the program.

“The House, with all due respect, cannot come up with a real reason we should not have a pill mill database in our state,” he said.

State Rep. Will Weatherford, R-Wesley Chapel, who is tapped to be the state House of Representatives’ next speaker, said in the days before the state announced it was moving forward with the database that HB 7095 is needed because doctors are dispensing addictive prescription drugs that wind up on the illegal market. 

“We no longer will allow [doctors] to dispense them,” said Weatherford. “They can write prescriptions, but they can’t dispense them.”

And the database itself?  “It’s a tool. We’re looking at it,” he said. The governor hasn’t said he wants to move forward with it, he said.

“Until he says that he would approve of it, it’s kind of moot,” Weatherford said.

Fasano has introduced a bill (SB 818) this legislative session that requires doctors, administrators and pharmacists to take a one-hour course in using the PDMP if they want a new license in the state or want to renew an old one.

Under Fasano’s bill, penalties for illegal pill trafficking are made harsher. Doctors who violate state law when prescribing medication can have their license suspended by the Board of Medicine or Board of Osteopathic Medicine for at least six months and be fined for at least $10,000. The bill also requires that dispensed medications be reported to the PDMP within seven days of handing out pills, not 15. In addition, it removes the provision saying the state can’t use taxpayer money to fund the database.

The bill goes before the Senate budget committee April 14.

State Rep. Janet Cruz, D-Tampa, is a big proponent of the PDMP, said her aide Kathy D’Onofrio.

“I can tell you that Rep. Cruz has a lot of these pill mills in her district,” D’Onofrio said.  “We shut them down, they open them up. We shut them down, they open them up again. So it’s a real problem.”

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State Rep. Rick Kriseman, D-Gulfport, said that people are coming to Florida to take advantage of a state that does not track prescriptions.

“We have people coming from out of state to our state to obtain prescription medication,” Kriseman said. “And that’s a problem.”

Scott’s call for the elimination of the drug monitoring program and veto of pill mill legislation earlier this year is bad policy, he said. 

“This is just another example of the governor being out of touch,” he said.

State Rep. Darryl Rouson, D-St. Petersburg, knows what addiction can cost a person and their family. Rouson was addicted to crack cocaine and alcohol. He went through rehabilitationtreatment at the Mayo Clinic and the Hazelden/Hanley clinic in West Palm Beach, and he learned what addicts went though while recovering himself.

“I heard it in group. I heard it on family days, when family members came up and confronted their loved ones,” he said.

Rouson said before the program got the green light that HB 7095 “punishes” individuals and small pharmacies. The Legislature can do better than that. There’s another way, he said. 

“I think the aggressive way to deal with this is both avenues, funding the database and curbing vendors and users,” Rouson said.

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