After years of increasing scrutiny as it sat at what appeared to the epicenter of the national prescription painkiller abuse epidemic, Florida implemented a law requiring that every prescription filed for controlled substances such as prescription painkillers be recorded in a statewide database. A year later, Tampa Bay Times reporter John Woodrow Cox has followed up to see what difference the law has made.
The answer appears to be “hardly any.” Because there is no requirement to use the system when writing prescriptions, Cox writes, “the vast majority of medical practitioners have never touched the much-touted database.” He has assembled some damning numbers to back that observation up.
- Since the system’s inception on Sept. 1, 2011, more than 48 million prescriptions have been written in Florida for controlled substances — that’s about 2.5 for every man, woman and child in the state. Prescribers, however, checked the database before writing just 2 percent of them.
- Among physicians in the Tampa Bay area permitted by the federal government to prescribe these potent drugs, fewer than one in 12 has ever used the database.
- A Times reporter surveyed all 91 local pain-management clinics registered with the state and that appeared to be in business. Fewer than half reported using the program. Employees at 46 of the clinics declined to answer questions or did not respond to calls. One acknowledged never using the program.
Cox digs pretty deep into the issue, but in the end it comes down to a simple observation: When it comes to enforcement, there is neither carrot nor stick. Scrupulous voluntary use of the database would only mean less business for the “pill mills” which account for so many of the state’s prescriptions, so they have no incentive to check it and face no punishment for not doing so. The experience of other states indicates that requiring prescribers to reference the database would make it more effective, but such a mandate appears impossible given Florida’s current political climate.