By Dave Bowen

One pill can kill.

Prescription drug abuse is the most threatening substance abuse issue in the State of Florida.  According to the 2010 Florida Medical Examiners Commission Report on Drugs Identified in Deceased Persons, prescription medications such as Benzodiazepines and Oxycodone, Methadone, Morphine and Hydrocodone caused the most deaths of drugs tracked by this report.  The report also identified that 2,710 of the individuals died with at least one prescription drug in their system that was identified as the cause of death.

Florida is widely recognized as “ground zero” for what has become a national prescription drug abuse epidemic, with states as far as Maine suffering the consequences of the overprescribing of prescription drugs in Florida.

Florida accounts for 89 percent of all the Oxycodone sold nationwide last year. A very high percentage of the access to Oxycodone came from “pill mills,” which are cash-only convenience stores for painkillers, often advertised as pain-management clinics.  Not only are drug-seekers flocking to our state, but the illegal operations of these pill mills also impacts legitimate patients in need of specialized treatment from true Pain Management physicians.

In an effort to thwart individuals who “doctor shop” and hop from pharmacy to pharmacy, filling multiple prescriptions for powerful narcotics, the Florida Legislature in 2009 approved the creation of the Prescription Drug Monitoring Program (“PDMP”) database. This initiative encourages safer prescribing of medications and reduces drug abuse and diversion in the state, while complying with federal health-care privacy law. Florida Attorney General Pam Bondi hailed the program as “another step forward in Florida’s fight against prescription drug abuse.”

When  tough economic times prohibited state funding for the database, the Legislature authorized fundraising through a Direct Support Organization (“DSO”), leading to the creation of Florida’s PDMP Foundation. The PDMP Foundation board of directors includes a county sheriff, a former director of the Florida Office of Drug Control and representatives from the business community.  Having spent the majority of my career in healthcare, I was excited to give back to the citizens of Florida by serving as Florida’s PDMP Foundation  chairman.

The PDMP Foundation received nearly $500,000 in start-up contributions. Aegis PainComp Testing Services, Millennium Laboratories and Automated HealthCare Solutions were the top funding sponsors. Citizens and law enforcement agencies have also donated to help start the program. The state received additional funding in grants from the federal government and national groups.

The Foundation used this seed money to launch the statewide monitoring program earlier this year. The online database went live in October, giving Florida physicians and pharmacists access to vital information on patients’ prescription histories. In just the first few weeks of operation, more than 5,000 pharmacies and other dispensing locations have entered more than 18.5 million prescriptions for controlled substances into the database. In addition, 4,800 health care practitioners have reviewed patient information in the database. This launch has been the most successful that I know of in the nation, due largely to the support it has received under the leadership of Florida Surgeon General Dr. Frank Farmer and the tireless work of Rebecca Poston, Program Manager and Erika Marshal, Program Operations Administrator.

When U.S. Attorney General Eric Holder visited Tampa in late October to speak about Florida’s prescription drug crisis, he noted that Florida, for too long a source of the problem, is now becoming part of the solution, thanks in part to the Prescription Drug Monitoring Program. Holder hailed monitoring programs as among the most effective tools to curb doctor shopping.

Not all of us have had addiction or drug abuse affect our lives that closely. You may ask, “Why should I care about an issue like this?” Whether we like it or not, prescription drug abuse has a far-reaching impact on our communities, and it touches us all in a variety of ways. Two professors at the University of South Florida in Tampa highlighted one of those alarming ripple effects earlier this month: Florida leads the nation in the number of newborns addicted to prescription drugs because of their mothers’ drug use.

The researchers said in a recent editorial for the St. Pete Times that the number of these addicted newborns has nearly quadrupled in Florida during the past five years. The mothers’ drug use increases the risk of slower weight gain and sudden infant death syndrome for these babies.

The news among teens isn’t much better. Prescription drugs have become the second-most abused illegal drug, behind marijuana, among 12- to 17-year-olds, according to the Florida Office of Drug Control. These young people represent our future. We cannot sit idly by and let prescription drug abuse ruin their potential. They won’t be the only ones who are hurt. We all suffer when so many are left behind.

The good news is we have the technology to attack the problem. Doctors and hospitals across the country are embracing electronic medical records as a means to deliver higher quality care at lower costs. Florida’s new prescription drug monitoring program is a wonderful complement to those technological innovations in medicine. The database offers benefits to doctors and patients beyond just preventing the spread of prescription drug abuse. It can help save patients’ lives and improve the quality of care.

For instance, physicians can use the database to carefully review the various medications that are prescribed to an elderly patient. This is a critical issue in a state with so many retirees who have substantial health-care needs. Doctors can use the database to ensure new prescriptions don’t pose dangerous interactions with other medications that already are being taken.

This also can help doctors reduce excess prescriptions that end up sitting unused in medicine cabinets across the state. These leftover pills are one of the biggest sources of diverted drugs. Enough painkillers were prescribed in 2010 to medicate every American adult for 24 hours a day for one full month, according to the Centers for Disease Control and Prevention. Studies show that the majority of teens who abuse prescription drugs get them from family and friends for free, often from the home medicine cabinet.

Consider what Americans turned in last month (OCT 29) during the National Prescription Drug Take-Back Day. The U.S. Drug Enforcement Administration collected more than 188 tons of unwanted or expired medications at 5,300 sites across the United States. That helps remove a major source of drugs. But the bad guys aren’t going away, so we can’t get complacent or think our work here is done.

Despite the recent federal crackdown against questionable pain clinics and unscrupulous doctors, officials have still seen a dramatic increase in the number of new pharmacy applications. Law enforcement officials say many of them are likely pill mills that should be denied.

The Florida PDMP is a big step in combating the scourge of prescription drug abuse in our state.  But more resources are needed to continue the initiative. The Foundation has set an annual fundraising goal of $750,000 to help keep this crucial database running.

Please consider helping our foundation raise the funds necessary to operate a highly effective prescription drug monitoring program and database. We’ve already sent a powerful message that we won’t tolerate the status quo. It’s imperative we keep our momentum going and find the resources for the battles ahead.

For more information on donating to the Florida Prescription Drug Monitoring Program Foundation Inc., go to www.flpdmpfoundation.com or call chairman Dave Bowen at (954) 874-2116.

Dave Bowen is chairman of the Florida PDMP Foundation, Inc., a 501(c)(3), non-profit organization. He also is president of Automated HealthCare Solutions in Miramar, FL.

E-FORCSE is the State’s new electronic database of specific controlled substance prescriptions, which has been collecting records since Sept. 1.  Currently, 5,219 dispensers have uploaded more than 15 million controlled substance prescription records into the database. In addition, 1,500 health care practitioners have requested access to view their specific patient’s information stored in the database.

“More than seven Floridians die a day due to prescription drug overdose,” said Attorney General Pam Bondi. “The launch of the Prescription Drug Monitoring Program will allow doctors and pharmacies to prevent doctor-shopping and over-prescribing of highly addictive pain medication. Today marks another step forward in Florida’s fight against prescription drug abuse.”

The Prescription Drug Monitoring Program (PDMP) database was passed into law during the 2009 legislative session in an effort to abate prescription drug abuse in Florida – which at the time had become the hot bed for oxycodone abuse nationwide. Through generous donations from companies like Automated HealthCare Solutions, Aegis PainComp® Testing Services, Millennium Laboratories™ and private citizens and law enforcement agencies, the database was launched in 2010.   For a list of sponsors visit www.FLPDMPFoundation.com.

“On behalf of the members of the Florida PDMP Foundation, we are pleased to see so many physicians and pharmacists are already using this lifesaving database,” said Dave Bowen, chairman of the Florida PDMP Foundation and president, Automated HealthCare Solutions.  “This database is aimed at cracking down on prescription drug abuse and making sure medication gets into the hands of the people who truly need it while keeping it away from the bad actors who have been abusing the system.”

The database will track controlled substance prescriptions as defined in section 893.03, F.S. that are filled in Florida, capturing the name and dosage of the controlled substance, where it was filled and who wrote the prescription.  Physicians, pharmacists and dispensers can use the database to determine what medications are in the best interests of a patient and to guard against “doctor shopping” – illegally seeking a prescription from multiple physicians.

The Florida PDMP Foundation, Inc. and the Florida Department of Health (DOH) reminded prescribers, dispensers and practitioners, that access to the database started this week.

“The severity of prescription drug abuse in Florida cannot be overstated and utilizing this database is one tool that will aid us in winning this battle,” said Florida Surgeon General, Dr. Frank Farmer. “The Department of Health is committed to working with our local and state partners to protect the health of all residents and visitors in Florida with the common goal of stopping countless, senseless deaths.”

Business leaders, law enforcement officials and other members of the community serve on the Florida PDMP Foundation board, which is a non-profit organization that works to save lives by raising awareness and funds to implement Florida’s PDMP.

“When pain clinics began to outnumber McDonalds and Starbucks in Broward County we knew it was high time to get a handle on the pill pushers,” said Broward County Sheriff Al Lamberti, one of Florida’s PDMP board members.  “We weren’t accustomed to seeing drug dealers in lab coats, working out of shopping centers, but that’s what we had. The PDMP is already yielding positive results and we will continue to monitor its progress along with state and federal authorities.”

E-FORCSE is compliant with the Health Insurance Portability and Accountability Act (HIPAA) as it pertains to protected health information (PHI), electronic protected health information (EPHI), and all other relevant state and federal privacy and security laws and regulations. The information collected in the system will be used by the PDMP to encourage safer prescribing of controlled substances and reduce drug abuse and diversion within the State of Florida. More information about E-FORCSE can be found at http://www.doh.state.fl.us/mqa/PDMP/home.html.

“More than seven Floridians die a day due to prescription drug overdose. The launch of the Prescription Drug Monitoring Program will allow doctors and pharmacies to prevent doctor-shopping and over-prescribing of highly addictive pain medication. Today marks another step forward in Florida’s fight against prescription drug abuse.”

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State Senator Mike Fasano Announces that E-FORCSE (Electronic – Florida Online Reporting of Controlled Substances Evaluation), the prescription drug monitoring program, goes “live” today.  All physicians in Florida will now have the ability to access the prescription drug history of patients in Florida.  The monitoring program came about due to efforts of Senator Fasano and others over the pat ten years.  Senator Fasano was the prime sponsor of various pieces of legislation during the past decade that led to the launching of the database.  The database will assist physicians in identifying both doctor shoppers as well as patients who may not be using their medications properly.

“The prescription database is perhaps the single most important patient safety program to launch in recent memory,” Senator Fasano states.  “On average, the scourge of prescription drug abuse claims the lives of seven people per day.  This long-awaited tool is intended to cut that number significantly.  After many years and many obstacles to overcome, the database is going live at a time when it is needed most.  Although we will never know the number of lives that will be saved, we will know that many lives will not be lost as long as the database is consulted by every doctor every time he or she considers writing a controlled substance prescription.”

The database will track all controlled substance prescriptions (C2- through C4) that are filled in Florida.  The information contained in the database will include the name and dosage of the  controlled substance, where it was filled and who wrote it.  Doctors can then use that information in determining what medications are in the best interest of their patient.  If the data shows that the person is “doctor shopping” (the illegal practice of seeing multiple doctors in a short period of time to secure the same or similar medications without disclosing that fact) the doctor can either refuse to write a prescription or assist the patient in the pursuit of substance abuse treatment.  Many doctor shoppers sell their medications, which is also a crime.  The database will assist law enforcement in curbing the proliferation of this dangerous criminal behavior.

“The database, as well as legislation recently passed by the Florida legislature, will cut down the ease of access to prescription drugs by those who may abuse them or sell them,” Representative Richard Corcoran states.  “With pill mills being shut down due to the ban on dispensing drugs from most doctors offices, and the launching of the database, Florida is on the road to becoming a safer and healthier state.”

The Florida Medical Association and the Florida Osteopathic Medical Association have both encouraged their respective memberships to consult the database.  It is Senator Fasano’s hope that in the interest of both public and patient safety that all doctors will see the database for what it is intended to be: a tool to save lives.

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