Misguided monitoring program . . .

February 17, 1992

If the legislature is looking for ways to save money, we have a suggestion: Cut out an item in the Department of Health and Mental Hygiene's budget that provides funds for a statewide program to track prescriptions of Schedule II drugs -- substances like morphine that have important medical uses but a high potential for abuse. It sounds good, but it won't work.

In past sessions, the legislature has defeated efforts to institute a more cumbersome monitoring program that would require triplicate copies of prescriptions for these drugs. But the department's new version would not require legislative action and can be instituted by department regulations -- assuming the money is there.

The problem with these monitoring programs is simple. Officials at the federal Drug Enforcement Administration insist that prescription drug abuse is a problem, but their evidence is largely anecdotal. There is no strong, reliable evidence that prescription drug abuse is a significant part of Maryland's overall drug problem.

But prescriptions are an easy target -- easier than trying to track and prevent diversion of addictive drugs from pharmacies, for instance. So federal and state officials eager to demonstrate they are actively fighting drug abuse can monitor prescriptions of potentially addictive drugs and, in all likelihood, come back in a year or two with statistics to show that their program has led to a drop in consumption of these drugs.

That has been the case in other states where prescription monitoring programs have been adopted. And who suffers? Not people who buy these drugs on the streets, where other sources will fill the demand, but rather patients with cancer and other terminal illnesses who find that their doctors are more reluctant to prescribe opiates in doses strong enough to control their pain. Is this any way to tackle drug "abuse" -- especially in the state which bears the stigma of leading the nation in the number of cancer deaths?

The bigger problem with Schedule II prescriptions is that physicians get so little training in pain relief that they often let their patients suffer needlessly. Thus far, the evidence from other states shows that prescription monitoring programs only exacerbate this problem. At a time when health care dollars are too scarce already, we see no reason for the state to spend money on a program that could easily cause more problems than it could ever hope to solve.

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