Drug Policy

The Dangers of Federal Snooping into Our Prescription Drug Records

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Former Reason man Radley Balko from his new perch at the Washington Post points out the dangers of prescription drug user databases, especially when government agencies get access to them without court order.

After discussing a recent legal challenge to the practice in Oregon, and how Pennsylvania is trying to create more records of its citizens prescription drug use for government snoops to enjoy:

Imagine a law enforcement officer looking for ammunition in a divorce or custody dispute. Or perhaps a politician who takes the wrong position on police pensions or police accountability might see his painkiller scripts leaked to the press. (That sort of retaliation wouldn't be unheard of.) Moraff points out that Virginia's prescription database has already been accessed by hackers, who then threatened to release the records of 8 million people.

But [there's a] less obvious problem—the chilling effect this will have on doctors. For example, one of the red flags federal investigators look for when looking for doctors to accuse of "drug dealing" is the overall number of prescriptions a given doctor writes for various controlled drugs. That means that as he's deciding your course of treatment, or whether to prescribe opioids to improve your mother's quality of life as she's dying from terminal cancer, he'll be thinking about how many scripts for those drugs he may have already written for other patients. It's an intrusion on the doctor-patient relationship, and could influence a doctor's decisions about a patient's treatment with factors that have nothing to do what's best for that particular patient.

Jacob Sullum's 1997 classic on the unconscionable war on pain meds needs to be read and re-read.

Previous Reason writings on 'scrip drug databases.

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  1. HIPAA already has a law enforcement exemption for individual investigations, but how in the name of all that is Holy can they possibly justify a blanket exemption for a fishing expedition?

    1. What is this “justification” of which you speak?

      1. Fuck you, that’s why, of course.

    2. HIPAA also has an exemption for any disclosure that is “required by law.” Make reporting of prescriptions to a database mandatory, and HIPAA is not an issue.

      1. Excellent point. But a broad exemption in a case like this pretty much guts HIPAA entirely as it’s a fishing expedition across entire groups of patients and providers.

        But as Ted S. mentioned, fuck you, that’s why.

  2. And this will only grow massively worse with Obamacare. Yay!

    1. But kids take their these drugs out of their parents’ medicine cabinets. That commercial said so!!

      1. If a single person might get their hands on prescription pills that weren’t intended for them, it’s a disaster. We need to stop giving them to anyone just in case!

        I typed that as a joke, but they actually think like that. It’s insane.

        1. They really do. Every time I see one of those commercials I laugh my ass off. Who, other than a cancer patient, keeps enough pain pills in their house for your kid to get addicted by stealing them? If that happens, I think the parent probably has a problem too.

          It has to be the dumbest and most insane justification for a law I have ever seen.

          1. Who, other than a cancer patient, keeps enough pain pills in their house for your kid to get addicted by stealing them?

            These days a lot of insurance companies require that you purchase 90 day supplies of drugs. That includes drugs for chronic pain. Oh, and not all chronic pain is cancer related. So that situation is not as far fetched as you ignorantly believe.

            1. Even if you have a 90 day supply, if you kid steals enough of them to feed an addiction, you are going to notice it.

              If you honestly think that kids stealing meds from their parents and getting addicted is anything but nearly nonexistent problem, I don’t know what to tell you.

              1. All I said was that the situation where the pills are available is not as far fetched as you ignorantly believe. I said nothing about how often the pills are abused by someone else in the house. Nice straw man you ignorant asswhipe.

              2. I’m wih John. Pain patients tend to be pretty frikkin’ fanatical about their meds. They know they have to make their prescription stretch over the intended period. “Diversion” to their kids is taking pain pills right out of their own mouths, and they know it. No way a kid could be snitching enough pills to get addicted without their parent knowing.

                1. No way a kid could be snitching enough pills to get addicted without their parent knowing.

                  I never made that argument. I was only addressing the question of availability.

                  1. My point is not that kids don’t steal pills. It is that that problem such as it is is so small that it is irrelevant to the debate and people who make it are either ignorant or just want to use scare tactics.

            2. Yeah, that is definitely not as rare a situation as John seems to believe. Maybe grandma had fibromyalgia or something and doesn’t quite understand what the pills they give her for it are.

              And of course that’s still no reason to punish the people who do need the pills or the doctors who give them to them. Better that 100 junkies get to do their thing than one patient suffer needlessly or one doctor be punished unjustly for writing “too many” prescriptions.

              1. And to respond to some of the comments above, no, a situation like that will be very unlikely to provide anyone with enough drugs to sustain a serious addiction. But I have known a couple of old ladies who really didn’t quite seem to understand the pain pills they were taking. One was on oxycodone and would occasionally not take them because she didn’t like the dopeyness it sometimes caused and then wondered why she felt so crappy. And she would do this every few weeks. And she left it lying around the house.

              2. Fucking 3 o’clock squirrels. Try this again.

                I was talking about this one day with the old widower next door, and he said that after his wife died he threw out a box of pills. And not a shoe box. We’re talking jars and jars and jars. And a lot of them were serious pain medication.

                1. I had a boss several years ago who was telling me about how his wife’s mother had died recently, and they had–as you describe–jars and jars, just tons, of pills, many of which were serious pain pills. When he told me they ended up just throwing them out I yelled at him for a few minutes. He had the decency to be sheepish about being so stupid.

                  1. Well, Epi it looks like my neighbor and your boss were both wrong because John declared that that never ever happens.

                  2. Some people hate the feeling of pain pills and just tough it out. My mother was like that. Yes such stashes exist. But I just don’t believe that they are common enough to be relevant to the overall debate.

                    1. They’re not common. Trust me on this, because I am on a constant lookout for anyone who has pills they no longer want.

                    2. Trust me on this, because I am on a constant lookout for anyone who has pills they no longer want.

                      My wife too.

        2. I propose legislation for mandatory prescription medication locks.

          1. I propose legislation for mandatory prescription medication locks

            Drugs must be kept locked in a FDA approved drug safe at all times. Law enforcement has the right to enter the home at any time of anyone on prescription medication to make sure the law is being enforced.

            Anyone caught asleep with drugs on the night stand, and fluffy gets it, and then it’s off to the slammer and kids put into state care.

            For the children.

            1. Restricted Firearms Drugs must be kept locked in a RCMPFDA approved firearm drug safe at all times. Law enforcement has the right to enter the home at any time of anyone possessing a Restricted Firearms License on prescription medication to make sure the law is being enforced.

              Anyone caught asleep with Restricted Firearms not locked/securely stored drugs on the night stand, and fluffy gets it, and then it’s off to the slammer and kids put into state care.

              For the children.

              This is literally the law for what is deemed a Restricted Firearm in Canada (Handguns, any firearms with a barrel shorter than 18.5″, etc.).

              1. Tulpa supported this for guns after Newtown. Even the fuck you to the 4th Ad part.

      2. I’m sure the kids do that. And nearly all of them manage to survive the occasional vicodin or percocet taken for amusement.

        1. That is just it. stealing the odd pain pill is not being addicted. Beyond that, we shouldn’t be putting our nose into doctor patient relationship because occasionally God thins the genetic herd by having some kid be dumb enough to OD.

          1. Indeed. Other people being dumb should never justify extra interference with peoples medical treatment.

      3. The local radio station is running a locally-produced (I think the county health department or something) PSA on this topic, and it’s hilariously bad. Almost as bad as the “I learned it from you, Dad” PSA.

  3. Something something Dunphy something something something?

  4. The entire idea that the feds have any interest in what a doctor proscribes to his patients is appalling. We have state licensing. If a doctor spends his time proscribing to addicts or misproscribes and his patients start showing up dead, that is an issue for him and the medical board. But if none of his patients complain and no one dies, the government has no business second guessing his professional judgement. Fuck these evil bastards.

    1. Really, the idea of supremacy only makes sense in the federal system if the federal governments powers are limited and generally do not overlap with the states.

      The whole point of that was that most power would default to the state (assuming it was a legitimate government power and consistent with the state’s constitution, of course), so the very little conflict the state power would have with the few federal powers needed to be resolved. So the federal government got supremacy. Not a good thing when the federal government has general police powers.

      1. It is terrible. The feds now effectively control the licensing and credentialing of doctors. You doctor can’t write you a script without the feds having their say in it. That is not a free society.

        1. I hope Paul somehow gets elected and guts the whole thing. Kill it.

      2. Really, the idea of supremacy only makes sense in the federal system if the federal governments powers are limited and generally do not overlap with the states.

        Which poses the question, if federal powers are not limited, why the need for state government at all? One size fits all federal regulation for everything.

        1. You just wrote what a lot of progs think.. as long as their guy is in charge, that is.

        2. Say, you’re right? Kill the states!

  5. My nephew died of an overdose of his Aunt’s cancer medication. She just left them on the table. Her son died the same way in a prior incident. I am, in no way supporting police intrusion into prescription pain meds, but please don’t discount the pain and loss of these types of incidents. They do happen.

    1. I am sure they do. And I am sorry for your nephew, though I must ask how old he was. It is actually pretty difficult to kill yourself with these things. Get yourself in the emergency room, sure. But you really have to take a lot of them and maybe drink a lot to kill yourself.

      Just a question, but did your nephew have a drug and alcohol problem to begin with? I find it unlikely that some innocent kid who never smokes or drinks and doesn’t have some kind of pre-existing drug problem would manage to kill himself by stealing his aunt’s pain meds. Maybe, but pretty rare.

      1. He was 29 years old and had a 5 year old son.

    2. I’m not trying to be a douche – I’m sorry about your family’s suffering – but that seems like a bit of a non-sequitur, since increased government snooping wouldn’t have prevented it.

      1. It could have if they just would have not given the woman pain meds and told her to suffer. That would have prevented it. And sadly, I think a lot of people at the DEA are totally on board with that solution.

        1. I had a coworker who, thanks to some back injuries and botched back surgeries, carried around several 90 day supplies of various opioid pain killers. He would voice his ardent support for the war on drugs when he wasn’t nodding off. The irony was totally lost.

          1. Did he keep those things under lock and key? Some people can’t see past the end of their nose. I mean he got his meds. What is the problem?

            1. He carried them around in a cloth bag. Oh, and I guess the irony of someone supporting the war on drugs while nodding off in an opiate-induced haze was lost on you as well.

              1. Dude, what is up your ass? John isn’t being a dick, he’s just making observations.

              2. It wasn’t at all. Why do you think that? I guess the irony of him getting his drugs and not seeing the problem was lost on you.

        2. My mom has MS. It’s virtually impossible for her to receive sufficient pain care nowadays, and this is why. Left hoping for Florida passing medical marijuana in November, because otherwise she can’t find anything to help her.

          1. From what I can gather, it seems like pot is particularly effective for MS related pain. Of course most of that evidence is anecdotal. Too bad no one is allowed to really study it.

          2. The War on Drugs is evil, and the people supporting it are evil. My sister was diagnosed with MS five years ago, and I worry about what the future holds for her.

      2. There is no non-sequitur. I specifically said that I was not in support of increased snooping.

        1. Sadly, I don’t believe your story, and I don’t think many others are inclined to either.

          It’s one of those “too convenient” stories.

          However, your denouncement of increased inteference makes me reconsider.

          1. I don’t always agree with Jesus, but I’ve never known him to be disingenuous.

            1. It was more meant as a commentary, such claims are so common as a way to distract from the real issue, that I have to dismiss them.

              No offense was intended.

              1. Those things do happen. It’s sad and possibly tragic, but no reason to mess with other people’s medicine (or recreation for that matter). Unless it was a little kid who thought it was candy or something, the person who ODs takes that risk knowing what might happen.

    3. Your story needs more background and context.

      1. “Your story needs more background and context.”
        To accomplish what? My nephew had a hard life, some of it his own fault but some of it completely out of his control. He had a bit of a drug problem. Not a “giving blow jobs in the parking lot for $10” problem, but still an issue. He was divorced and had a school age son. His Aunt left her meds out in the open. She has been a cancer patient for years and apparently has loads of medication.

        While he was staying at her place, he got into the medication and ended up dead. We don’t believe it was suicide. It was probably just stupidity and carelessness. Although it may not be legally true, I hold his Aunt partially responsible for leaving her meds out in the open when she knew he had a drug issue.

    4. What’s the H stand for?

        1. This guy is just a heratic. Everyone knows Jesus’ middle name was Tap Dancing.

          1. I thought it was “Titty Fucking”.

            1. Zeb you infidel.

              1. Wars have been fought over smaller disagreements.

      1. Habsburg. He is his own cousin.

  6. Lets not forget there is more to medicine than pain pills. Suppose that someone that the powers that be don’t like takes anti-depressants. I am sure they wouldn’t leak that information to the hack media to embarrass them or anything. Or if that person maybe cheated on his wife or got a little freaky with his wife and another person and caught an STD, no government hack would ever leak that information. And the threat of such a thing happening would never chill dissent. I mean the government having access to your medical records would never cause someone to think twice about getting cross ways with the government. I mean that could never happen. It is not like Linda Tripp and Joe the Plumber and any number of other people happened to embarrass the government ever had their private records released or anything.

    1. Are they talking about making a database of all prescriptions or just controlled substances? I don’t think most anti-depressants are controlled. But lots of other psych meds are, so I think that danger exists in any case.

      1. Doesn’t the infamous Obamacare electronic medical records mandate pretty much do that?

        1. Probably. When does that kick in?

          The real shame about that is that electronic medical records are a great idea in a lot of ways. But you just know that someone is going to abuse it when it is a government mandated program. I feel like HIPPAA or whatever it’s called is pretty useless when it doesn’t protect your privacy from the government. I’m really a lot less worried about private people seeing my medical records.

          1. I work in healthcare IT. It kicked in last week.

  7. Somewhat related: I have a blocked Eustachian tube and the only thing that treats it is pseudoephedrine. I have to take at least four of them a day in the winter. I managed to max the out the amount I am allowed to buy over the counter very quickly and ran afoul of the meth reporting law. Yeah. So love the government looking over my shoulder.

    I had to get a prescription to be able to get the amount I needed, and it needed a DEA number, just like if I was getting opiates.

    1. Maybe you should just switch to meth. It’s more effective as a decongestant at a much smaller dose. And quite possibly less of a hassle to get.

  8. I’ll be having my knee reconstructed soon. I’ll be interested to see what they do for pain meds.

    1. Try not to let them hook you up to one of those “self-dosing” boxes. They are nothing but torture machines. They always program them so that the meds wear off a few minutes before you can dose again, so you just writhe in agony, desperately pushing the button until the time is up. I’d like to skin the diabolical fucker that thought that shit up, then roll him in salt and bleach.

      1. I’ve been on them and mine was timed for a dose every 15 or 20 minutes. It worked great. It probably depends on who sets it up.

    2. I think these things can vary a lot depending on where you are and who your doctor is. It’s really weird how it works out sometimes.

      I had a friend who broke his ankle in a bad way. Had to have complicated surgery with plates and screws and everything.

      They tried to give him Vicodin after the surgery. Once the nerve block wore off he was in agony. So they gave him a shit load of Dilaudid. Like, way more than he needed.

      It seemed really weird. Going directly from completely inadequate pain meds to complete overkill.

      1. That tracks with what I have heard, one friend got vicodin, another oxycodone.

  9. I’m so glad to see that Balko is bringing the Friday Nut Punch to the WaPo.

  10. 2 clicks away, the ground not-so-subtly changes:

    http://www.sciencedaily.com/re…..142027.htm

    Balko cites a Phila. journalist who in turn points to developments in the USA as part of global undertreatment of pain by opiates?but in the countries cited as part of the “global” problem (the USA is not considered one in that report), the problem is said to be one of lack of enough funding & infrastructure to make all the opiate drugs available. Interesting.

  11. Sounds like some serious business.

    http://www.AnonWork.tk

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