We know that Florida established a much needed Prescription Drug Monitoring Program, but left it unfunded and in danger of collapse. We know that the Florida legislature, in addition to not allowing state funds to be used, expressly prohibited pharmaceutical companies from contributing, despite the offer of $1 Million from the makers of Oxycontin for just such a purpose. What we haven't discussed was that the legislation that produced this baby for abandonment also lacked one other key ingredient.

No one is required to use it.

It now appears that, in true form, the Florida medical community has aligned with the intended spirit of the legislation and is largely ignoring this database and the almost 50 million records it contains. A Tampa Bay Times investigation has discovered that “the vast majority of medical practitioners have never touched the much-touted database”. The investigation found:

  • Since the system’s inception on Sept. 1, 2011, more than 48 million prescriptions have been written in Florida for controlled substances — that’s about 2.5 for every man, woman and child in the state. Prescribers, however, checked the database before writing just 2 percent of them.
  • Among physicians in the Tampa Bay area permitted by the federal government to prescribe these potent drugs, fewer than one in 12 has ever used the database.
  • A Times reporter surveyed all 91 local pain-management clinics registered with the state and that appeared to be in business. Fewer than half reported using the program. Employees at 46 of the clinics declined to answer questions or did not respond to calls. One acknowledged never using the program.

This really isn't a surprise. Without a requirement that prescribers use such a database, as well as associated penalties for not complying, most people will not change their daily habits. Even those practitioners who believe they are acting responsibly with their patient's pain medications and regimen may not utilize a system that requires a new procedure or checkpoint be used. The fact that we are talking about people's safety and lives aside, new habits take time to develop, and the old adage “out of sight, out of mind” truly applies.

Without a mandate from the state, that habit isn't going to happen. We should applaud those responsible enough to use this system, and the state needs to revisit this issue. They've had the baby. Now they need to arrange for its feedings, give it some teeth, and make sure people know it is there.

Otherwise it appears that we are just kidding ourselves about addressing prescription drug abuse. The only new habits that will continue to develop on this topic will be the same old bad ones we were supposedly trying to break.

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