Monday, October 22, 2007

Arrests for pain, anxiety drugs worrisome for legitimate patients

I get a little edgy when police start making arrests for a legal pharmaceutical that I've been prescribed recently by my personal physician: It makes me wonder under what circumstances I could become a target?

Over the last year or so I've struggled with some health problems that caused my doctor to prescribe one of the medicines now named by drug enforcers as a primary target, according to the Houston Chronicle ("Southeast Texas called 'mecca' for pill pushers," Oct. 22). So if I'm driving or out in the world and have my medication with me (as I've been advised to), if a cop sees me with it will I be arrested?

I wonder: How much documentation must I carry with me to imbibe prescribed medication? Under what circumstances would possession be illegal and when would it be okay?

I was also disturbed to learn about a bill signed by Governor Perry that I'd missed during the 80th Legislature, expanding DPS regulatory authority to include most medicines. That's just wrong: I want doctors regulating my prescriptions, not cops! Reported the Chronicle:

The DEA classifies drugs in "schedules" or levels, based on the risk of abuse. Drugs such as lysergic acid diethylamide (LSD) and heroin are considered level 1 and have no accepted medical use in treatment in the U.S.

The level 2 drugs, such as the painkiller OxyContin, are available by prescription but are regulated at the federal level by the DEA and at the state level. Pharmacies electronically transmit prescription information to the Department of Public Safety, which works with licensing boards to identify doctors and pharmacists who may be inappropriately prescribing or dispensing drugs.

This summer, Gov. Rick Perry signed a bill that would expand monitoring by DPS to include level 3 through level 5 drugs, which would include Xanax and drugs combined with hydrocodone, which are levels 4 and 3, respectively.

State Sen. Tommy Williams, R-The Woodlands, said he sponsored the bill to give Texas law enforcement agencies the tools to investigate drugs that are classified as less prone to abuse by requiring all prescriptions for controlled substances to be sent electronically to DPS. The official enforcement date for the law is September 2008.

Still, some law enforcement officials in Texas argue that hydrocodone and Xanax should be grouped with more addictive drugs and targeted separately — not with other schedule 3, 4 and 5 drugs. They are pushing for the Legislature to reclassify hydrocodone and Xanax as level 2 drugs, which would make them subject to far greater scrutiny, similar to OxyContin, officials said.

"We have to change the overall approach that the state has in regards to regulation, " said Houston Police Lt. Gray Smith, with the narcotics division.

Honestly, I don't want my prescription information transferred to DPS, and I don't think most Texans know that that happens. Did you? I'm fairly shocked by it. I wonder what they do with all that data?

What do you think? Why should state troopers have access to Texans' prescription information? And should criminal law enforcement focus its limited resources on tracking what drugs your doctor gave you or how often you renew your prescription? Does that make you feel safer, or less safe?

ADDENDUM: This story from KHOU gives a fuller picture of the real problem: If the real source of crime is stolen or black market drugs, how does it help to gather information on legal prescription holders?

21 comments:

Anonymous said...

HIPAA - AS (Health Insurance Portability and Accountability - Administrative Simplification) Federal regulations prevent the electronic transmission of my health data without my consent.

Doesn't the government need a warrant to search my health information?

Data about Dr. prescribing patterns can have patient details "de-identified". Is this a requirements of the new law?

This law should be tested in the Courts on day one!!!

Catonya said...

exactly what I was wondering...
I thought a warrant was needed to break doctor/patient confidentiality?

Anonymous said...

Imagine that you had prescription medicine in your pocket, in the vial from the pharmacy, with the prescription information written on the label, with the helpful little tag describing the labeling and color of the pills. Now, a cop frisks you 'for weapons', or some other trumped up nonsense, finds the vial, and calls it in. There's a screw up on their end, so he gets a no-hit. Now he arrests you on one or more narcotics charges, and he won't let you have your medicine while you're in jail, so you go without until you make bail and get to see your doctor for an emergency prescription.

Did you appreciate the fact that the cop is practicing medicine without a license?

Anonymous said...

I've written about this a million times, especially when news stations such as channel 13 does whole segments on it. (usually only telling PART of the story!)

Here was my Post on it:



Painkiller Jane....why ABC 13 sucks
Category: News and Politics

Imagine this scenario:


You suffer from chronic pain all your life, you have moved to a new State and you have to find a doctor to treat your pain. After years of trying different medications, you've been placed on a regimen of specific painkillers per day. These don't take away your pain completely, however they do make it so your quality of life is decent enough.


BUT… after moving, you make appointments with doctor after doctor. Each of them saying the same thing… they are afraid of prescribing a narcotic due to public backlash such as "undercover news reporters catching doctors prescribing them".

Of course, that doesn't make sense right? After all, you have legit pain… the doctors know that you have legit pain… however it doesn't matter because of the recent outcry.


The cause?

A teenage girl overdoses on a COMBINATION of prescription drugs and dies.


ABC 13 ran a story about this the other night. What they seriously glossed over was the fact that she died from a COMBINATION of pills, NOT just the painkillers which they would have made you to believe AND which they focused on in their report.


So…lets go back to the hypothetical "you" for a second… you have now been to a number of doctors and your pain grows worse daily to the point where YOU want to die.

Instead of getting sympathy, you are instead met with accusations now… because NOW you have what appears to these outraged parents and reporters … to be "Doctor Shopping".


Ah yes… what a nice circle of events eh?

It is these types of "News Reports" that are making it impossible for doctors to actually TREAT their patients without fear of possibly being bugged or video recorded.


As a patient, you are supposed to go into the doctor's office and tell him/her your symptoms. In order for the doctor to treat you properly, they expect that you are being honest with them, after all, they didn't go through all that schooling for nothing. (However, it seemed to be easy for that reporter to fib about HIS pain in order to get painkillers for his report, one has to wonder about THAT)

NOW, some doctors refuse to treat patients and refer them to the ER BECAUSE of incidents such as this "news report" we find on ABC. It is reports like this that is making it almost impossible for people with chronic pain to find relief. (I'd like to know how many places they had to go to before they found someone that would give them ANYTHING and heres MY view:

"They went into a PAIN MANAGEMENT CLINIC and complained of pain and the doctors gave what is usually the ONLY relief for chronic Sufferers... PAINKILLERS..

IMAGINE THAT!!"



It's bad enough that these people face judgment and humiliation. Most I have talked with say that even when they HAVE a doctor treating them, when they go into the pharmacy to fill their prescription, they are met with flat out disgust and the pharmacy staff treats these people like they are drug addicts off the street.


Instead of putting up the link to the Texas Medical Board to complain… why aren't the PARENTS monitoring their children? In an age where blame is given to every single entity, (The teachers, the schools, the classmates…) why isn't it placed where it belongs? I know while I was growing up, my mother knew every little piece of dust that was in my room and we knew that if we even so much as LOOKED at ANY drug, our father (who was also a Police Officer) would whip our ass. So, I believe it's wrong to place blame where it doesn't belong and SHAME on ABC 13 for placing that link on their site and not telling the COMPLETE story, not to mention the other side of the story. I just can't believe they are trying to make a Doctors job even harder than it is by not only trying to put a leash on them, but also making it so they don't want to TREAT people with the fear of even more bogus lawsuits and news reports. So, here's the million dollar question….


The doctors are doing THEIR job… are the Parents?!

Anonymous said...

Let's keep in mind that most senior police officers, after years of abusing their bodies, surviving high speed collisions, and brawling, are continually on steroids and painkillers.

Their hypocrisy is boundless.

Anonymous said...

Unfortunately, there are patients who go fishing for prescriptions by seeing putiple doctors and getting multiple prescriptions for the same medication. These same patients then either are taking too many pills or are selling the medications on the street.
Unfortunately not all Doctors do their due dillegence and cordinate with each other to prevent this from happening. Plus, the information is only a reliable as the information the patient provides. A database can help catch such individuals...still not sure that it will actually deter the problem or how it relates to Hipaa.

Still I am n

Anonymous said...

Sorry you're having health problems, Scott.

Main thing is, carry your prescription in the prescription bottle. And don't be drinking alcohol on it, or you will go to jail. Most of those meds tend to "enhance" with the addition of even a small amount of alcohol.

Unless being arrested for some other crime or for a warrant, I cannot see an officer arresting you for poss of xanex or vicodin, the only two drugs I saw mentioned in that article.

Anonymous said...

Anonymous said...
Imagine that you had prescription medicine in your pocket, in the vial from the pharmacy, with the prescription information written on the label, with the helpful little tag describing the labeling and color of the pills. Now, a cop frisks you 'for weapons', or some other trumped up nonsense, finds the vial, and calls it in.


A police officer is not allowed to reach into your pockets for anything, unless he "believes" it's a weapon. Most cases the police officer will "ask" you to empty your pockets, but your under no obligation to do so! If a cop ask you to empty your pockets, tell them you wish not to.

Gritsforbreakfast said...

But why should it be a cop's business if I don't want to carry around the damn prescription bottle? People take their drugs out of the original packaging for many reasons that aren't illegal.

And while I understand a prohibition on driving and consuming alcohol with prescription drugs, the statement "don't be drinking alcohol on it, or you will go to jail" is exactly the kind of overreach I think isn't justified.

I feel about this the same way I do about arresting cancer patients for medical marijuana. The health problems that make me NEED the drug are trouble enough. If I'm minding my own business and not harming anyone, the words "jail" and consumption of "medicine" really IMO should seldom if ever go together. best,

Anonymous said...

I carry around a couple of my pills. I HAVE to because I'm away from my house most of the day. I never carry it around in my bottle, which would mean if I lost it, I would be accused of lying, just to get another script. Also, as for the anonymous post..it's not up to the DOCTOR to find out if the patient has been to other doctors getting the same script... it's up to the Pharmacies. If it's in a certain Class of drugs, the pharmacies are able to determine whether or not the person has filled it at another pharmacy..unless they are using someone elses name.

Anonymous said...

Scott, I do hope you are not a victim of the Texas "Reverse Lottery" and win the Prison Sentence.

Another approach to protecting yourself is to have a huge war chest full of money to hire lawyers that will protect your right to take medicine.

I still fail to see the Public Safety enhancement in this scenario. Very troubling!!

Anonymous said...

Our horrible "Gotcha" society has gone too far. It went too far quite some time ago.

Anonymous said...

Most senior police officers are continually taking pain killers and steroids? What an ignorant statement! Back your assertion with something that supports your claim.

Anonymous said...

I am seeing more and more of this issue nationwide- Florida, Tennessee and more; as people continue to abuse prescription drugs the more the rest of us who actually NEED them are at risk for this type of fear and regulation. Example- the VA here in TN is now
doing "pill counts" as well as drug tests. Veterans are subject to this at random of course. What is next?

Anonymous said...

I wondered why I had to provide my DL # to the pharmacist when I received my last pain killer prescription. Now, it suddenly makes sense.

This is horrifying.

Anonymous said...

Scott, I also have scripts for schedule 3 and 4 meds. I am aware of the law and so to comply have to lug them around with me in a script specific bottle for both meds. I try to keep just a few pills in a bottle with a date within the last year, but I hate that they come in bottles 4 inches tall and 2 inches in diameter. I just hope I never get a hassle because the date on the bottles is a few months old. My meds are expensive and needed on a daily basis, so much so that if the house were on fire they would be one of the first things I grab. Does DPS or the lege really want me to risk losing all my meds to a purse-snatcher just to keep them in the legally current and correct bottle? Meds you need on a daily basis should always be close at hand when you are away from home because there are any number of scenarios in which you could be stuck away from home overnight or longer. Try walking into a strange pharmacy and getting your meds under those circumstances!

And for all the people who make jokes about women carrying purses with everything but the kitchen sink in them, now you know why. I would also point out that when we leave the house I also get to carry hubby's meds too, since most guys don't carry a purse. Multiply me by several million women who do the same.

Anonymous said...

I am a Registered Nurse and the HIPPA law does prevent doctors and pharmacies from giving your information to anyone without your consent.

There are a lot of people who suffer from depression and the anxiety that accompanies the depression is only controlled with an anti-anxiety drug i.e. Xanax or Ativan or Klonapan. These are level two drugs and for any policeman or DPS to arrest anyone who has a bottle with their name on it and issued by a licensed physician, should never know that person takes this medication. Who ever thinks up the law like this should have to suffer from this debilitating disease, and it is a physical condition, the brain lacks a chemical and on medications, that person functions normally. This is none of any one's business but the person taking the medication and the physician. After all he has a long education learning about these medications and what he gives his patients to help them maintain a normal lifestyle should never be divulged to anyone DPS or policeman. We are not allowed to even tell someone over the telephone is so and so is a patient without consulting the patient or their representative.

Get real whoever you are in Congress and Gov. Perry, this is none of your business. Leave our doctors to do their jobs and until you obtain a medical degree, stay out of people's lives!!!

PostalMed said...

Saw your post and the comments and I just had to make some comments of my own and correct some inaccuracies being posted here. So you'll know that I know what I'm talking about, I am a physician licensed to practice medicine in the state of Texas.

"So if I'm driving or out in the world and have my medication with me..." --- Having your meds with you in your car is not illegal, else how would you ever get them home from the pharmacy? But if you're taking a controlled substance (whether or not the pills or bottle is in the car) and you are pulled over for driving erratically, you are guilty of a DUI just as if you had been consuming alcohol (and under the same statute as for alcohol).

"I don't want my prescription information transferred to DPS..." --- If you have been prescribed Sched 2 drugs, this information has been being sent to the DPS for years. As far as Texas "reclassifying" hydrocodone as Sched 2, I doubt that they could, as the Schedules are set by the Federal DEA. However, the states can also regulate drugs and could easily pass legislation singling out individual drugs (hydrocodone, alprazolam, carisoprodol) for special attention as if they were Sched 2. (PS: I think Xanax [alprazolam] and Soma [carisoprodol] should be removed from the market. Each is a dangerous drug and each has safer alternatives.)

"HIPAA - AS (Health Insurance Portability and Accountability - Administrative Simplification) Federal regulations prevent the electronic transmission of my health data without my consent. Doesn't the government need a warrant to search my health information?..." and "I am a Registered Nurse and the HIPPA law does prevent doctors and pharmacies from giving your information to anyone without your consent..." --- The misinformation about HIPAA continues. HIPAA does indeed provide privacy protection for medical information. However, HIPAA specifically excludes governmental bodies and law enforcement from these provisions. The DPS can legally ask for and collect prescription data without your or my consent. And they don't need a warrant if the purpose of such a request is for investigating possible criminal activity. They can (and usually do) stipulate in addition that we doctors, hospitals, etc., are prohibited from informing you the information has been collected. (I also am waiting to see this get challenged in the courts. Of course, I think the entirety of HIPAA is unconstitutional.)

"Unfortunately not all Doctors do their due dillegence and cordinate with each other to prevent this from happening..." --- Believe it or not, here HIPAA actually PREVENTS doctors from communicating or coordinating to stop this from happening. HIPAA allows us to share information when we are jointly and simultaneously caring for a patient, but to call around to see if Drs. Smith, Jones, or Harris might have prescribed Vicodin for any given patient is prohibited.

"Why should state troopers have access to Texans' prescription information?..." --- The purpose is twofold. One is to try to find doctors prescribing excessive amounts of controlled substances. What chills us doctors to the core is how they might define "excessive". An oncologist treating many patients with metastatic cancer could inadvertently be considered an "excessive" prescriber. The second reason is to identify the real doctor shoppers who are obtaining, fraudulently, multiple prescriptions from multiple doctors for the purpose of selling it on the street. In fact, since the passage of HIPAA, the only times I have become aware of the fact that a patient was doing this was when I was informed, by the DPS, that patient X had gotten recent prescriptions from Drs. A, B, and C. (Those patients were immediately sent packing.)

As has been posted elsewhere on this thread, there are unscrupulous individuals in Texas running prescription mills. The DPS, being the only real law enforcement agency of the state, has been given the task of preventing the illegal diversion of controlled substance inside Texas. And tracking presciptions is the only simple way to find these mills. Right now only mills for Sched 2 substances can be found this way, but mills for the Sched 3 agents like hydrocodone and alprazolam abound, and state law enforcement has no easy way to find them. One such mill (for Vicodin primarily) was busted up near where I live a few years ago and it took almost two years of undercover work to get enough evidence to arrest the doctor. The problem is that hydrocodone, because it's so easy to obtain in large quantities, is becoming increasingly the most widely abused prescription drug, and something has to be done to stop this. (Though I will admit I think the current efforts are too heavy-handed to really be effective.)

BTW, I learned today from a pharmacist that beginning two weeks ago, the DEA has started a nationwide policy of limiting the quantity of hydrocodone tablets that any single pharmacy can sell in any one month. Anyone else know anything about this? Besides the fact that this is a horrible restraint-of-trade issue for the pharmacies, does anyone think this is going to help reduce illegal diversion, or is it just going to massively inconvenience or outright harm legitimate users of this drug? (After all, does anyone really believe restricting pseudoephedrine sales over-the-counter has reduced one whit the production of crystal meth?

PostalMed
Rantings of a Medical Mind
www.medicalrantings.blogspot.com

Donlety said...

You should opt for xanax only after getting hold of a xanax prescription and altogether it is essential to take xanax in accordance with the instructions of a physician. So, take xanax as per the instructions of the physician and get rid of anxiety at the earliest!

Agony said...

Even decongestants are considered illicit drugs now according to the patriot act. Why don't they just get it over with and ban all drugs. Ban surgery while they're at it. I'm so sick of being tortured/protected by my own government. Liberty...right

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