Tuesday, March 01, 2011

Who Owns Governor Rick Scott?

Once you realize how common pill addiction has become in this nation - how many people are addicted to pills, how many pills they take, and how many pills are diverted from legitimate markets to illicit sales, it becomes pretty obvious that 'legitimate' industries are involved. Sure, there are problems with doctor shopping, forged prescriptions, individuals who sell the drugs they are prescribed to take... Sure, there are doctors who are nothing more than drug dealers with prescription pads. Tens of millions of pills are 'stolen' between the point of manufacture and the point of sale. But when you read about a state like Florida, it's reasonable to infer that there's a lot more to the picture:
Turns out that Florida medical practitioners bought 41.3 million oxycodone pills in the first half of 2010, almost 10 times more than their counterparts in all 49 other states combined. There is simply no legitimate explanation for that.
And there's no way that pharmaceutical companies aren't tracking those highly profitable sales, or that they don't know that Florida's doctors are purchasing far more pills than the population of the state could reasonably be expected to need. Under Jeb Bush, Florida had slowly started to take steps toward tracking prescriptions for controlled substances, a step that although far from perfect makes it much harder for doctors to engage in wholesale prescription fraud and drug dealing of the type recently seen in Florida.
Thirty-five states, including Virginia, and the District have found a way to manage the trade-off: prescription drug monitoring programs (PDMPs), paid for with both their own funds and federal grants. PDMPs generally require doctors and pharmacies to report dispensing of controlled substances to a central database, where the information is kept securely, available only to authorized persons - such as doctors and pharmacists - with a need to know if patients have a history of "doc-shopping." Studies by both the Government Accountability Office and a Justice Department-funded consulting firm have found that PDMPs deter overprescription and reduce the probability of drug abuse.

Florida, not surprisingly, lags in this respect. In 2009, the state established a PDMP to be funded only through private donations; it has not yet gone into operation. Newly elected Gov. Rick Scott (R) wants to repeal even that weak measure, calling it an invasion of privacy.
Why am I skeptical that Rick Scott's concern is privacy. Florida's not alone in this regard:
Perhaps more surprising, Maryland has done less than Florida has. This is especially troubling given that medical practitioners in Maryland purchased 423,000 oxycodone pills in the first half of 2010, more than those of all but three states, including Florida, according to Drug Enforcement Administration (DEA) statistics. That is eight pills for every 1,000 residents, 10 times the rate of California and 53 times the rate of New York.
Did you catch that? California's doctors, who have a reputation for being quick to prescribe pain pills to their legitimate patients, prescribe them at a tenth the rate of doctors in Maryland. We're talking about hundreds of millions of dollars here, folks. When I read about the governors of states in which massive diversion is occurring blocking modest measures that could help reduce that problem in their states, I think it's more than fair to ask, "What's in it for them?"

I'm not suggesting that they're in the pocket of their states' drug cartels. But let's not forget that when this much money is at stake, and when we're talking about the diversion of millions of pills, the legitimate side of the industry has a huge financial interest in preserving the status quo. Here's where some transparency could be useful - I would like to hear Governors Scott and Maryland's former governor, Robert L. Ehrlich Jr., explain why they worked so hard to block PDMPs in their states - including the identities of the industries that lobbied against the PDMPs and the amounts those industries contributed to the governors' election campaigns.

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