Drug Monitoring Likely To Expand, Despite ACLU Objections

The Oregon Drug Monitoring Program was enacted in 2009 to track the prescription of controlled substances, but the ACLU says private medical information was given to the Drug Enforcement Adminstration without a warrant


March 15, 2013 — Led by Sen. Jeff Kruse, R-Roseburg, the Senate Health Committee voted to expand the Oregon Prescription Drug Monitoring Program this week, approving a bill by 4-1 that would allow doctors to deputize their aides to review patients’ medical records and give the state pharmacy board the ability to expand the program beyond narcotics to any medications they see fit.

“Prescription drug abuse has become a national epidemic,” Kruse said.

Law enforcement are required to have probable cause that a crime is being committed to access the database, but last year the system was breached by the Drug Enforcement Administration, which argued that state laws don’t apply to the feds.

The state of Oregon sued the DEA, and the American Civil Liberties Union of Oregon has filed a motion to intervene in the case.

“The ACLU is extremely concerned because of this ongoing lawsuit that the PDMP is not secure, and we should be hitting the ‘pause’ button,” Becky Straus, the ACLU legislative director, told The Lund Report. “We’ve been very concerned about the collection of personal medical data. … That data is at risk.”

But Kruse said he traveled to Alabama last summer to learn about other state programs, and he felt Oregon had the best approach to contain the information and have security over the data. “This is all about patient safety, and this medical record thingy we are doing here is going to save lives,” he said.

Senate Bill 470 also expands access to doctors in California, Washington and Idaho who see Oregon residents. A separate part of the bill authorizes medical examiners to use the information for autopsies and an amendment will send out alerts to doctors and pharmacists when high levels of prescriptions have been ordered, particularly from multiple practitioners.

The full Senate will vote on SB 470 next week.

The Prescription Drug Monitoring Program was set up to stop doctor-shopping or drug-store shopping for prescription drugs that might be abused. A doctor or pharmacist could see who else may have prescribed or dispensed controlled medications and prevent a patient from getting duplicative prescriptions or allotments that exceed reasonable use.

The ACLU fought the program from the beginning. “It was certainly our fear when these discussions were happening in 2009 and it’s been confirmed that the privacy of these records is not secure, these private medical records,” Straus said.

Her concerns were enough to convince Sen. Chip Shields, D-Portland, to vote against the measure.

“In the prior sessions, I was a strong supporter of SB 355 (the bill that created the program), mostly because I wanted to get in the way of enabling people to remain in their addictions” said Shields, the sole opponent of SB 470. “I think that with this bill I have some concerns that we are going beyond creating some red flags for providers to encourage them to have discussions with their patients. Now we’re moving farther down the road of creating a electronic medical health record, which was not my attention at least.”

Shields’ usual ally on the committee, Sen. Elizabeth Steiner Hayward, D-Beaverton, disagreed with him, saying the drug monitoring program was a useful tool for her as a family physician, saying there are other drugs besides narcotics that are misused and should be tracked. “I see this as an adjunct that will help me provide better care,” Steiner Hayward said.

Tom Burns, the director of pharmacy programs at the Oregon Health Authority, said accessing the computer system to see which drugs have been prescribed to a patient can take several minutes — when doctor’s visits are lucky to last 15 minutes.

Burns said an aide could more effectively look over the records and relay the information to the doctor without wasting valuable appointment time.

Straus objected to expanding the access to people who might have much less professional certification than physicians and pharmacists, but Lincoln County District Attorney Rob Bovett said this aspect of SB 470 was crucial to get doctors to actually use the system.

“The Oregon PDMP is a tool of prevention,” according to Bovett’s testimony. “But like most prevention tools, our PDMP is only as valuable as it is actually used by prescribers and pharmacists.”

Bovett was clear to point out that the PDMP is not designed to be a law enforcement tool, but a drug abuse prevention program. He supplied graphs showing that while the percentage of people in drug treatment for methamphetamine has declined since 2005, the percentage of those in treatment for prescription drug abuse has been on the rise.

“I think this is a tool that will be utilized to a very high degree by physicians for better healthcare outcomes,” Kruse said.

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