Editorial: Florida

After years of silent complicity, Florida is finally beginning to acknowledge an epidemic problem exists, in terms of prescription drug distribution, particularly opiate based pain medication. This has been no secret. In recent years, states like Tennessee, Ohio, and Kentucky have publicly blasted the Sunshine State for creating an environment where even their best efforts are thwarted by Florida’s blind eye.

38 states have comprehensive prescription tracking systems in place that prevent the kind of ramped abuse that is commonplace in Florida, where a single doctor once wrote over a million Vicodin prescriptions without seeing any of the patients. Of the 12 states that do not have such a system, Florida is the largest and has by far the most physicians. Last year, a bill to create such a system was signed into law, but without funding; just another wink-nod in a history of pitiful negligence.

Currently, there is another bill before Governor Crist, but it still doesn’t go nearly far enough in arming law enforcement and regulatory agencies with adequate control to address the problem. This massive failure in government costs communities an incomprehensible amount in terms of tax dollars, resources, and family blight.

Detox clinics and outpatient rehabilitation centers are overburdened by the growing number of addicts and the cost to insurance companies, as well as state and county funded social programs, also continues to squander limited resources. Law Enforcement Agencies, prisons, shelters, courts, welfare programs, foster care homes, private businesses, social workers, and schools are all unfairly taxed when such a problem is ignored.

While researching a story last year, a young addict rode along the Tamiami Trail with me, pointing out dozens of ”no questions asked“ clinics where she could get a prescription written, and then often filled on the spot, for her fix of a benzodiazepine. It still amazes me when people debate the legalization of drugs, as if it hasn’t already arrived.

Ask a 14 year old what’s the easiest drug to get and they’ll rattle off a list of prescription meds, usually lifted from a parent’s medicine cabinet, not hustled from a dealer. Ask a police officer if the damage done to a family or community is greater for marijuana or RoxyContin.

The Bradenton City Council acted in admirable valor when taking this problem to task this week (PDF), and I commend Commissioner Barnebey for her leadership, but the cities and counties of our state should not be left alone to wage this war. Unlike most problems, the answer to this one is simple. The state doesn’t need physician registration and ”training.“ Pill mills do not exist because highly-educated medical doctors are unaware of their potential for disaster. They exist because they are part of a billion dollar industry and provide an opportunity for greedy people to profit on the pain and suffering of individuals, families, and communities.

First, Florida needs to ban the practice of businesses both writing and filling prescriptions. Medications that require a prescription do so because it has been determined that the potential dangers of their misuse warrant a physician’s discretion. There is an obvious profit incentive for a prescription to be written by a clinic that can then profit by its sale, and such a conflict need not exist. There are enough CVS’s and Walgreens in Florida for someone to get their medication filled elsewhere.

The state then needs to enact severe penalties, at least on par with illegal drugs, for doctors and other individuals who conspire to profit illegally from the abuse of prescription medication. I’m not talking about throwing the addict outside of the clinic in prison for 20 years and adding to the enormous cost of an already flawed policy. I’m talking about imprisoning the doctors and clinic owners and not in the kind of cushy ”white collar“ prisons where crooked hedge fund managers go to do time. In fact, you might even make a tour of Florida State Prison in Bradford County a requisite to getting licensed.

Right now, there is an improper distinction between someone dealing or using crack, meth, or heroin and someone doing the same with OxyContin. These drugs are more addictive and more dangerous than many of the so called ”street drugs“ that cannot be gained from a rigged prescription, and our current policy steers addicts toward them with easier access and less likelihood of criminal charges, that is until they’re burglarizing or prostituting to afford their fix.

Most importantly, Florida needs to implement a comprehensive computer tracking system that connects doctors, pharmacies, and regulatory agencies throughout the state and then hopefully to other states as well. When a doctor writes an inordinate number of prescriptions, he should be flagged immediately and investigated. When a person fills prescriptions from more than one physician or for an inordinate quantity of drugs, it should be flagged immediately so that both doctors and pharmacies can refuse to enable them. 

The cost of such a system is grossly outweighed by the costs created by its absence, and the fact that this has yet to be done should be an embarrassment to our state legislature. In this instance, Governor Crist has failed his constituents miserably and I hope he is questioned doggedly on the topic come fall, when he is asking Floridians to send him to Washington. Of the many services our government is charged with providing the people, this touches on the most fundamental; public safety, public health, and the preservation of our quality of life. 

If say, Georgia or Alabama were to legalize the growth and sale of the coca plant or opium poppy, it would be ludicrous to think that the problems would stop at their borders. That criminal dealers, organized crime elements, and ravenous addicts from other states wouldn’t show up to menace their communities and then return, transporting the problem to other states. Florida’s prescription drug policy is just as ridiculous and we owe our citizens, our communities, and our fellow states better.