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House May Roll Back Bill Expanding Drug Monitoring Program

Rep. Mitch Greenlick opposes allowing the Board of Pharmacy to add drugs to the tracking system that are not controlled by the DEA, aligning his concerns with the American Civil Liberties Union.
May 9, 2013

Editor's Note: This article has been amended for accuracy.

May 9, 2013 — Rep. Mitch Greenlick, D-Portland, has moved to scale back a measure that would enhance the Oregon Prescription Drug Monitoring Program, citing concerns raised by the American Civil Liberties Union.

The expansion bill was pushed in the Senate by Sen. Laurie Monnes Anderson, D-Gresham and Sen. Jeff Kruse, R-Roseburg, to help make the existing system established in 2009 more effective.

Senate Bill 470 allows doctors to deputize their employees to access the system on their behalf, lets doctors in neighboring states into the system if they have Oregon patients and allows the state’s chief medical officer to use the drug monitoring program in autopsy investigations.

But the bill as it passed in the Senate also gives the Board of Pharmacy the right to add drugs to the monitored list as it sees fit.

“They’re not going to add just any drug,” Monnes Anderson said. She said the board would only be interested in adding drugs that are abused but not supervised by the U.S. Drug Enforcement Administration.

Monnes Anderson said SB 470 is of personal importance: She has a relative who is addicted to prescription drugs.

The drug monitoring program tracks drugs with potential for abuse, such as narcotics and addictive anti-anxiety medicines like benzodiazepine, which can be lethal when used in conjunction with opiates. Currently only Schedule II, III and IV drugs that are controlled by the DEA are monitored in Oregon.

Becky Straus of the ACLU said that while her organization opposes SB 470 and the entire program, the potential drug expansion was the most troubling aspect since it would aggregate so much personal data.

Greenlick introduced an amendment on Wednesday that will remove the power of the pharmacy board to add any new drugs.

“I feel it’s really vital,” Greenlick said, preferring to pass SB 470 with the amendment on Friday.

Greenlick also introduced an amendment that would remove a provision whereby a doctor would receive an electronic alert if a prescription was potentially problematic based on the patient’s record.

The Senate would have to agree to any changes that the House makes, but Kruse and Monnes Anderson told the House Health Committee they would not fight an amendment that took the drug expansion portion out, so long as the heart of the bill — easing physician access — remained intact.

Only about 4,000 practitioners have accessed the system to check which drugs their patients have been prescribed, while 98 percent of pharmacists have used it to enter data, according to Tom Burns, the director of pharmacy programs at the Oregon Health Authority.

He said there are 2,000 prescribers who hand out 60 percent of all controlled substances in Oregon, and these providers had a particularly low compliance rate. Burns said his agency has applied for a federal grant to promote the monitoring program and get more doctors to use the system more frequently.

Burns said a big reason that many doctors and nurse practitioners don’t use the system is that it takes away face time from their patients in their busy schedules. SB 470 seeks to rectify this problem by giving practitioners the ability to let their staff access the system and include the information in the patient’s records.

“Now that we have it, we need to make it work,” said Greenlick, who supported that provision.

Eight senators voted against SB 470 in the Senate — two Republicans and six Democrats, including Sen. Chip Shields, D-Portland, who cited concerns that the program was stepping beyond its original intent to stem prescription narcotics abuse by tracking people’s medical information.

Straus said the U.S. District Court had recently allowed the ACLU to act as a third-party intervener in a lawsuit the state has filed against the DEA.

Police officers in Oregon need a court order based on probable cause of criminal activity before gaining access to the system.

The state is attempting to apply the same standard to the DEA, but the federal agency has claimed that Oregon laws do not apply and has moved to breach the system with an administrative subpoena, bypassing the courts.

“It is being used as a law enforcement tool by our federal government,” Straus said. “We worry that this is not the time to be expanding the program in any way.”