Mark Long, chief of the narcotics bureau for Montana's Division of Criminal Investigations, fears that if the drug registry fails, addicts and criminals will continue diverting pain medications and Montanans will keep dying from opiate overdoses at an alarming rate.
An average of 246 deaths related to prescription drugs have occurred in Montana every year since 2001, by Long's count.
“There are just too many unknowns that I'm uncomfortable with,” said Fitzpatrick, a Helena librarian who survived breast cancer and has suffered from painful fibromyalgia syndrome for more than two decades.
Fitzpatrick attended the American Cancer Society's second annual Montana Pain Initiative Conference and expressed her concerns to more than 150 physicians, pharmacists, pain patients, lawyers, law enforcement officials, social workers and nurses. Those professionals and others gathered Friday and Saturday at Missoula's downtown Holiday Inn to discuss how to responsibly improve Montana's pain treatment policies while keeping an eye toward the drugs' potential for abuse.
Long was invited to sit on Saturday's “legal panel” along with a civil rights attorney, a drug diversion investigator, a clinician, a pharmacist and a pain expert. He told the audience that doctors and pharmacists could use the database to see if patients are obtaining multiple prescriptions from numerous doctors, and assured them that law enforcement would have limited access and could not go on preemptive “fishing expeditions.”
“Some states have databases with open-ended search clauses,” he said. “I'm in law enforcement and I don't even think that's a good idea.”
Panelist Adam Wolf, a staff attorney with the American Civil Liberties Union in Santa Cruz, Calif., said such a database should employ rigorous standards to prevent law enforcement from conducting dragnet criminal searches.
“I believe the database that has been proposed here is not as protective of civil rights as it should be,” Wolf said. “Are we willing to sacrifice our medical privacy, the most sensitive, personal information we have? Do we want that information to be in a registry that is run by the government and can be accessed by the government?”
Starla Blank, the former director of Montana's Board of Pharmacy, has been working the Montana Board of Crime Control to design the database, and said safeguards would be in place to protect patients' privacy rights. She said in the 29 states with active Prescription Drug Monitoring Plans, the registry is used primarily as a source of information for practitioners and pharmacists in the care of patients and to help deter drug abuse. It is not a tool for law enforcement to access on demand.
The registry would be housed under the Montana Board of Pharmacy, Blank said, and would not be a tool immediately available to law enforcement.
“Only the people who are taking care of you have access to records,” Blank said.
Steve Bullock, the Democrat running for state attorney general, and Republican candidate Tim Fox both attended the conference and said they are proponents of the database.
Both candidates emphasized the need to design the registry responsibly and with an emphasis on patients' privacy, and praised the conference's multi-disciplinary dialogue.
Dr. Scott Fishman, chief of the division of pain medicine at the University of California-Davis and author of the book “Responsible Opioid Prescribing,” said law enforcement should be far removed from the equation.
Kristin Nei, government relations director for the Montana branch of the American Cancer Society, said her concern is that a Prescription Drug Monitoring Program would act as a barrier to effective pain management. The program is a narrow approach to a complex problem, she said, and targets an entire patient population over the actions of the addicted minority.
Even critics of the drug registry can see its benefits, and Fitzpatrick hopes that her presence at the two-day conference will help influence and shape its outcome.
“I know this drug monitoring program is probably going to go through, but I don't like it. So maybe I can help make it less onerous,” she said.
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