North Carolina Sheriffs Want To Know Who Is Taking Painkillers


Wow, is this ever a terrible idea.

Sheriffs in North Carolina want access to state computer records identifying anyone with prescriptions for powerful painkillers and other controlled substances.

The state sheriff's association pushed the idea Tuesday, saying the move would help them make drug arrests and curb a growing problem of prescription drug abuse…

Sheriffs made their pitch Tuesday to a legislative health care committee looking for ways to confront prescription drug abuse. Local sheriffs said that more people in their counties die of accidental overdoses than from homicides.

For years, sheriffs have been trying to convince legislators that the state's prescription records should be open to them.

"We can better go after those who are abusing the system," said Lee County Sheriff Tracy L. Carter.

In addition to the obvious privacy, doctor-patient privilege, and Fourth Amendment concerns, a policy like this is likely to exacerbate the undertreatment of pain. The sheriffs argue that giving them access to the database will help them catch doctors who over-prescribe and patients who shop from doctor to doctor when they're denied access to painkillers. I'm sure there are examples of both misbehaving doctors and patients. But in the past, law enforcement officials' definition of over-prescribing has sharply diverged from that of pain professionals. High-dose opiate therapy, a promising new treatment for chronic pain, has basically been cut off at the knees because of high-profile cases in which DEA officials, U.S. attorneys, and state and local law enforcement with no medical training have taken it upon themselves to decide what is and isn't appropriate treatment.

And the problem is self-perpetuating. As more doctors leave pain management out of fear, those left feel pressure to take on more patients. And the fewer doctors willing to prescribe pain patients the meds they need, the more doctors legitimate patients need to see to get proper treatment. Both are consequences of bad policy. And both are then considered by law enforcement to be signs of abuse.

Letting cops go fishing in patient databases for these "red flags" is only going to make it all worse. Sure, they may well find a few unscrupulous doctors, and perhaps some people who are using doctors to feed an addiction. But one thing that's almost certain to happen is that doctors are going to become even more fearful that every script is going to be scrutinized. Which means fewer of them will be willing to write them. Which means more pain patients are going to suffer, despite the fact that there are drugs available to help them.

Jacob Sullum's great 1997 feature on opiophobia here.