Prescription drug abuse has skyrocketed, and local state House representatives have passed a bill to address aspects of the problem. It awaits a state Senate vote.
As a nation, "We have, unfortunately, an insatiable appetite for drugs," said state Rep. Matthew E. Baker, R-Wellsboro, who sponsored a bill that creates a confidential prescription drug monitoring database for professionals who prescribe or dispense prescription medication.
It would replace the attorney general's existing Schedule II database, which tracks a narrow category of prescription drugs and does not make any information collected accessible to doctors and pharmacists. This new database would track Schedule II to V drugs.
The goal of the bill is to help doctors know who is in real need of prescriptions and who is simply "doctor shopping," especially the drug dealers, said state Rep. Garth Everett, R-Muncy.
"The real concern are people who are doctor shopping at a high level and selling (those drugs)," Everett said. "We do want to stop the individual also, but we're trying to clip the dealers out there, who are turning around and selling it to kids."
Even as Pennsylvania is ranked the ninth highest in the nation in the rate of drug overdose deaths, according to the federal Center for Disease Control, it is one of the last states to have such a comprehensive tracking system, Baker said.
The cost is high. Not only has $53 billion been expended on treatment and "funneling" offenders through the criminal justice system in the state, the number of deaths from prescription opiates was greater than deaths from heroin and cocaine combined in 2010, Baker said, citing the federal Drug Enforcement Administration's August report.
Baker attributed this epidemic to the "pain management revolution of the late 1990s," when patients' demands pushed production of these drugs, according to a pharmaceutical threat assessment. In 1991, doctors issued 76 million opiate prescriptions; by 2001, that doubled to 139 million. By 2010, it tripled, Baker said.
The bill addresses law enforcement, prevention and intervention.
"What we're trying to do is improve patient care and prescription practices as well as uncover drug diversion and identify doctor shopping, and provide training of health-care professionals in the identification and prevention of drug problems, and referrals where appropriate," Baker said.
As some patients "doctor shop," they go doctor to doctor for prescription medications, and some re-sell the drugs. A very small percentage of doctors illegally over-prescribe these drugs, as well, Baker said, and this database would raise a flag to all of those activities.
The issue is privacy. An amendment was passed that would require any doctor, pharmacist or law enforcement officer to file for a search warrant to access any information.
While Baker opposes that amendment, saying the current Schedule II database has no restrictions and this amendment would be a "step backward on the war on drugs," Everett compared the database to an officer rifling through his medicine cabinet at home - a search warrant should be required for either case, he said.
Even without the amendment, doctors, etc., would only check the database upon suspicion, not automatically, Baker said.
But is the database an overreach into patient privacy?
"Just because you use (prescription drugs), doesn't mean you're a (drug) abuser, and it's on those records forever," Everett said.
State Rep. Rick Mirabito, D-Williamsport, said the privacy amendment passed 119-75, which shows privacy is a big factor to most legislators.
"It's really to protect people from intrusive government," Mirabito said.
Mirabito said since the bill expands the database to more drugs, therefore more patients, the privacy measure protects those patients. Further, if police are seriously investigating someone, they would likely have probable cause anyway, Mirabito said, so he thinks it shouldn't hinder law enforcement efforts.
To Everett, a search warrant strikes the balance between treating the problem and intrusion on privacy.
"A search warrant seems fair," Everett said.