Privacy and Prescription Drug Abuse

Prescription drug abuse leads to death

In one of the most startling statistical reports to come out of Washington and the national media, Time Magazine (mobile version) carried an Associated Press story on 15 October 2010 stating that in 2007, more than 27,000 deaths were reported nation-wide by prescription drug overdoses.

Mark Twain wrote that there are three kinds of lies: Lies, damn lies, and statistics. Thus, one can reasonably wonder how many similar deaths go unnoticed and/or unreported.

The Time story cited a plan that will be funded by federal money beginning in 2011 to link interstate pharmacy data allowing pharmacies, police agencies, and physicians to check “suspicious” prescription medication patterns. If a patient’s record is flagged, physicians must decide whether or not to prescribe a controlled substance for the patient. This proposed action follows on the heels of an even more frightening national statistic as verified by White House sources: From 2008 through 2010, hospitalizations stemming in some way from prescription drug abuse rose at least 400 percent. That’s four HUNDRED percent, folks! What’s going on in America that would cause such a jump in ER visits and acute hospital care?

The story may go something like this:

Pearl is a middle-aged woman who lives in Miami with her adult, widowed daughter during the winter and in northern Nebraska in the warmer months where her husband works a large wheat farm. She suffers from the chronic pain of herniated disks in her back. Pearl is also physically and emotionally addicted to opiate pain medication. To prove her residency in Florida and Nebraska to write checks and obtain services, she obtained drivers’ licenses in both states unbeknownst to DMV authorities. (One usually has to surrender one state license in order to obtain a license in another state,) Pearl has a physician in Miami, whom she sees during her winter forays into Florida to escape the cold Nebraska winters. She also has a physician in the rural Nebraska town where she spends summers with her husband. These two physicians don’t communicate with each other because of confidentiality issues and Pearl, being an opiate addict, likes it this way. She regularly receives prescriptions for OxyContin, the Fentanyl patch, Ambien for insomnia and Valium for muscle relaxation. One dark and stormy night, Pearl mixes her codeine-based cough syrup with a bit too much of her opiates and benzodiazepines. Her respirations and heartbeat stop during her sleep and Pearl becomes another statistic of an accidental death stemming from prescription drug addiction and abuse that could have been prevented, perhaps, if her physicians and pharmacies had been on speaking terms with each other – either literally or electronically.

Civil liberties organizations and health information privacy advocates are opposed to the implementation of database sharing procedures. Others opposing any such notification system include Penny Cowan, founder of the American Chronic Pain Association, who fears that it may discourage those who legitimately need painkillers from seeking help out of the fear of being labeled as a “drug seeker” and summarily denied emergency or acute care. “What we never hear about,” Cowan told the AP, “is how people with pain who, because they take these medications, are able to function, to be a productive part of society.”

Never mind what’s in your wallet. What’s in your state’s pharmaceutical data base; who sees it, when, and why? Did you give consent to share information about your prescriptions? Would you give such consent if, by limiting your personal privacy, you could help prevent deadly drug overdoses?

The times, they are a-changin’ and you will soon need to answer these questions for your state lawmakers.

Pearl is a middle-aged woman who lives in Miami with her adult, widowed daughter during the winter and in northern Nebraska in the warmer months where her husband works a large wheat farm. She suffers from the chronic pain of herniated disks in her back. Pearl is also physically and emotionally addicted to opiate pain medication. To prove her residency in Florida and Nebraska to write checks and obtain services, she obtained drivers’ licenses in both states unbeknownst to DMV authorities. (One usually has to surrender one state license in order to obtain a license in another state,) Pearl has a physician in Miami, whom she sees during her winter forays into Florida to escape the cold Nebraska winters. She also has a physician in the rural Nebraska town where she spends summers with her husband. These two physicians don’t communicate with each other because of confidentiality issues and Pearl, being an opiate addict, likes it this way. She regularly receives prescriptions for OxyContin, the Fentanyl patch, Ambien for insomnia and Valium for muscle relaxation. One dark and stormy night, Pearl mixes her codeine-based cough syrup with a bit too much of her opiates and benzodiazepines. Her respirations and heartbeat stop during her sleep and Pearl becomes another statistic of an accidental death stemming from prescription drug addiction and abuse that could have been prevented, perhaps, if her physicians and pharmacies had been on speaking terms with each other – either literally or electronically.

Civil liberties organizations and health information privacy advocates are opposed to the implementation of database sharing procedures. Others opposing any such notification system include Penny Cowan, founder of the American Chronic Pain Association, who fears that it may discourage those who legitimately need painkillers from seeking help out of the fear of being labeled as a “drug seeker” and summarily denied emergency or acute care. “What we never hear about,” Cowan told the AP, “is how people with pain who, because they take these medications, are able to function, to be a productive part of society.”

Never mind what’s in your wallet. What’s in your state’s pharmaceutical data base; who sees it, when, and why? Did you give consent to share information about your prescriptions? Would you give such consent if, by limiting your personal privacy, you could help prevent deadly drug overdoses?