Popping Again: Drug Database and Pill-Mill Regulations Return From the Dead

In a major reversal, a powerful House committee today went along with using a prescription-drug database to help combat widespread abuse of painkillers.

The House Appropriations Committee approved an 86-page rewrite of an earlier bill designed to close unscrupulous pill mills that have popped up in recent years. House leaders had earlier wanted to scrap the database because of patient-privacy concerns.

The revised bill also would keep many pain-clinic regulations that earlier House proposals would have eliminated. What’s more, it would ban doctors from dispensing two categories of controlled substances in their offices and set up a new permitting process for pharmacies.

Attorney General Pam Bondi, who has made fighting pill mills a top priority, appeared before the committee and praised the rewritten bill.

“What you’ve given us is a comprehensive plan, and that is what we have been looking for to go after these dealers on every level,” Bondi said.

But the proposal immediately drew objections from some independent pharmacists and doctor groups. The pharmacists, for example, said small pharmacies would unfairly be hit by the permitting requirements, which would start taking effect Jan. 1.

Rep. Mia Jones, D-Jacksonville, said she was concerned the bill focuses more on pharmacies than on pill mills that have become magnets for addicts and traffickers.

“Our problem is the pain-management clinics and the pill mills, and we need to focus on the problem,” Jones said.

But bill sponsor Rob Schenck, R-Spring Hill, said lawmakers have to make tough decisions to fight the “scourge” of prescription-drug abuse. He said those decisions included going along with the database.

“It is an ugly, nasty problem,” Schenck said. “And in order to fix that, sometimes we have to do things we are uncomfortable with.”

The pill-mill issue has been heavily debated during this year’s legislative session. House leaders and Gov. Rick Scott fueled the controversy when they proposed eliminating the database, which is expected to help track prescriptions and stop addicts from “doctor-shopping.”

Schenck said Scott also has indicated support for the revised bill.

The database was approved in 2009 but has not started operating, at least in part, because of a bid dispute among contractors. But state Surgeon General Frank Farmer on Friday signed a legal order to clear the way for the database.

The bill, however, would make changes in the database. It would require information to be entered into the database within seven days of a controlled substance being dispensed, after the original law called for 15 days.

Also, the bill would prevent drug manufacturers from helping fund the database, which has not received state money. That comes about a month after Purdue Pharma, the maker of OxyContin, offered to contribute $1 million to the database.

The revised bill also would keep many of the regulations that lawmakers passed in 2009 and 2010 to try to combat prescription drugs. That includes a registration process for pain clinics.

House leaders have argued that banning doctors from dispensing dangerous painkillers is the most effective way to fight the pill-mill problem. The bill would ban doctor-office dispensing of controlled substances such as oxycodone and also set up a registration system for doctors who prescribe those drugs.

Toni Large, a lobbyist for the Florida Orthopaedic Society, raised concerns today about both the dispensing ban and the doctor-registration requirements. She said, for instance, that the dispensing ban should not include one category of controlled substances, which includes drugs such as hydrocodone.

Small pharmacies also have been concerned about the bill, after an earlier version would have prevented some of them from dispensing the controlled substances. That earlier version would have allowed dispensing only by corporate pharmacies, such as CVS and Walgreens, or independent pharmacies that have been around more than 10 years.

The revised bill would require many mom-and-pop pharmacies to go through a permitting process by Jan. 1 to dispense the drugs. That requirement would have an exemption for corporate pharmacies and independent pharmacies in business for more than 10 years.

Schenck said those corporate and older pharmacies would have to be permitted when their licenses come up for renewal.

–Jim Saunders, Health News Florida

Jim Saunders can be reached at 850-228-0963 or by e-mail here.