Civil Liberties

Missouri Is the Only State Not Tracking People's Prescriptions


12th St David/Flickr

Missouri is the only state in America without a prescription drug database, which The New York Times describes as "the primary tool the other 49 states use to identify people who acquire excess prescriptions for addictive painkillers and tranquilizers," as well as the doctors who overpresribe them. In 49 states, the government is keeping track of what prescription medications you take. 

That's a little disconcerting, no? While these databases are touted as ways to combat prescription painkiller abuse and trafficking, most states require doctors and/or pharmacists to report prescriptions for any number of medications, including AHDH and anti-anxiety drugs such as Ritalin, Adderall, and Xanax. This database then can, and sometimes must, be consulted by future physicians prescribing drugs. 

Missouri state Sen. Rob Schaaf (R-District 34) and a small group of other legislators have been fighting against pressure—from medical groups, "members of Congress from neighboring states," the White House, and drugmakers—to institute such a database. Schaaf, a family physician, says allowing a government database of prescription drug records is a privacy violation.

"There's some people who say you are causing (painkiller addicts) to die—but I'm not causing people to die. I'm protecting other people's liberty," Mr. Schaaf said in a recent interview in his Senate office. "Missouri needs to be the first state to resist, and the other states need to follow suit and protect the liberty of their own citizens."

Mr. Schaaf's steadfast opposition has come under sharp criticism from fellow Republicans, including a United States representative, Harold Rogers, Republican of Kentucky, one of eight states on Missouri's 1400-mile perimeter. "It's very selfish on Missouri's part to hang their hat on this privacy matter," Mr. Rogers said. "The rest of us suffer."

That is some pretty warped logic: We're all supposed to happily give the government access to our private health records in order to help them "save" prescription painkiller addicts (which, for all the talk of a painkiller epidemic, are likely not as prevalent as drug warriors and public health officials would have you believe). But what do government officials do when they find out someone has multiple painkiller prescriptions? They arrest, fine, and often inprison them. We're supposed to give up privacy to help further enable to the police state and prison industrial complex in this country? (No thanks!)

In the absense of a database, Missouri is deputizing pharmacists to directly go after those "acquiring fraudulent drug prescriptions." The New York Times piece seems largely supportive of this, along with drug database and monitoring efforts in general. The article ends with Casie Hammon, a Missouri woman who was arrested by a pharmacist/sherifff after filling prescriptions for 171 days' worth of hydrocodone and 140 days' worth of other painkillers in a 70 day period.

Hammon has been charged with a Class D felony for fraudulently trying to obtain a controlled subtance and is to be obtained in August. 

In an orange jumpsuit and handcuffs, Ms. Hammon sobbed as she spoke with a detective inside the Scott County sheriff's office interview room.

She explained that scoliosis kept her in pain and that surgery a few months before made her need more and more relief. She described how she visited several doctors for extra painkiller prescriptions, but said that she did not know that was illegal.

While Detective Caid sorted through more empty bottles and pharmacy receipts, Sheriff Rick Walter watched Ms. Hammon on two monitors and became convinced that she was not selling her pills, but taking them herself.

Sheriff Walter said that his small force, even with an armed pharmacist like Mr. Logan, was simply outmanned to deter the drug abuse already occurring in Scott County, and that cases like Ms. Hammon's would increase if Missouri did not get a database.

"I understand what they're saying about privacy, I really do," Sheriff Walter said. "But look at this—this is just one woman, one family. Those kids, they're wondering where Mama is tonight. She's hooked on painkillers, because the system allowed her to be."

No, Sheriff Walter, clearly you do not understand people's privacy concerns, any more than you somehow don't understand that it is you keeping "those kids…wondering where Mama is tonight." She's "hooked on painkillers" in the face of genuine medical problems and the system wants to take her from her children and keep her in prison because of it. 

I fail to see how any of this is helping people, but it's pretty clear how these databases could be abused.

As Christopher Moraff wrote at Pennsylvania's The Patriot News earlier this year, "if registries are an invasion of privacy for citizens who voluntarily choose to buy a gun, surely they are for those who have no choice but to be sick." And: 

If the potential of having the federal government nose around in your private medical data isn't worrisome enough, consider that in 2009, hackers stole the records of more than 8 million patients from Virginia's prescription database and threatened to sell them on the black market if a $10 million ransom wasn't paid.

There's also little evidence that strict monitoring systems are effective in stemming prescription drug addiction and abuse—even data from the pro-monitoring Trust for America's Health calls the benefits of such initiatives into question. But such initiatives can have a "chilling effect" on how doctors treat patients. Physicians who fear being investigated for overprescribing may unnecessarily withold medication from those who could use it. 

"Viewed through this lens," writes Moraff, "legislation that trades off patient privacy as an alternative to tried-and-true remedies to drug addiction and abuse is a political red herring that places far too much power in the hands of investigatory agencies at a cost to consumers." Just to sum things up here: in the lesser-talked-about war on prescription drugs, we seem to be jailing and ruining the lives of people in physical pain instead of helping them, and using this as justification to give guns to pharmacists, interfere with doctor-patient privilege, and intrude on everyone's medical privacy. Am I leaving anything out?