TAMPA --Patients seeking painkillers are subject to a rigorous screening process at Deborah Tracy's office.
Tracy, a pain management physician in Spring Hill, now has an even better chance of making sure she's not prescribing narcotic-grade pills to addicts. She checks each patient's history against an online database that, since its launch in October, has grown to track about 21 million prescription records.
"It helps me as a tool, to use more due diligence," said Tracy, the president of the Florida Society of Interventional Pain Physicians. "It helps me tremendously."
Using the prescription drug monitoring system, Tracy said, she was able to identify several people who appeared to be doctor-shopping, visiting different doctors in a short period to obtain prescriptions for opiate-based pills such as oxycodone and hydrocodone.
Without the tracking system, she said, she would've never known they were addicts or drug dealers.
"Some of them lie pretty well," Tracy said. "I query all new patients. And you can do it within seconds."
The database, known as the Electronic Florida Online Reporting of Controlled Substances Evaluation, or E-FORCSE, has been in the works for about three years.
Gov. Rick Scott initially opposed the tracking system last year, but Attorney General Pam Bondi and several GOP legislators pushed for it to be included in a bill that toughened laws regulating pharmacies and pain clinics.
Under the new law, pharmacists and other health professionals who prescribe narcotic-grade medication have seven days after the painkillers are dispensed to patients to report the information to the database. Only doctors, pharmacists and law enforcement officers working active investigations can access the database.
The system launched Oct. 17. The state Department of Health released a report last month that detailed how the database has performed since it went online.
So far, 5,787 medical professionals have registered to use it, according to the report.Within two months of the database's launch, those health professionals checked the prescription histories of 106,414 patients.
"Right off the bat, these figures are encouraging," said Greg Giordano, chief legislative aide for state Sen. Mike Fasano, R-New Port Richey.
Fasano sponsored the Senate version of the bill last year calling for the creation of the database as well as strengthening regulations governing the ownership and operation of pain management clinics.
This year, Fasano plans to file legislation to eliminate the seven-day grace period for doctors to enter prescriptions in the database, Giordano said. Fasano wants the system updated as soon as a doctor files a prescription or a pharmacist dispenses it.
Bondi also was pleased that the system has run smoothly.
"I'm encouraged that, although this database has only been running for a short time, doctors and pharmacists have been reporting prescriptions and viewing patient-specific information," Bondi said. "We are well on our way to protecting Floridians from prescription drug abuse."
Thirty-seven states have prescription drug databases up and running. Lawmakers in 13 other states are seeking to create their own online systems.
The lack of a statewide database in years past and Florida's once-lax laws contributed to an increase in the number of so-called "pill mills," storefront clinics that dispense massive amounts of painkillers, law enforcement officials said.
State and local officials consider the Tampa Bay area and parts of South Florida as epicenters for pill mills and prescription drug abuse.
August 29, 2011
State Lifts Prescription Drug State of Emergency
Florida Tribune Staff, 08/29/2011 - 03:26 PM
Just days before a new drug database is set to start operation, the state of Florida announced that it was lifting the statewide public health emergency it declared due to Florida's prescription drug crisis. State officials first declared the emergency back in early July and then swept through clinics across the state for inspections that yielded in the seizure of hundreds of thousands of prescription drugs. “While the statewide public health declaration may no longer be in effect, the efforts of the Florida Department of Health, law enforcement partners and other state agencies remain strong,” said Gov. Rick Scott in a statement.
Scott had set up a task force to go after pain clinics back in March. Scott initially was opposed to keeping intact the proposed drug database - which is meant to track prescriptions issued by doctors for drugs such as OxyContin, Valium and Xanax. But Scott, lawmakers and Attorney General Pam Bondi reached a compromise that kept the database which is scheduled to become operational this Thursday. A bill passed this past session also requires physicians to submit their prescription informationwithin seven days.
Dr. Frank Farmer, the Department of Health secretary, also announced along with lifting the state of emergency he was also lifting a moratorium on a part of HB 7095 that had been put on hold.
Two months ago Farmer put on hold a requirement that as many as 50,000 Florida-licensed physicians use counterfeit-resistant prescription pads. The move was taken in the wake of phone calls from patients and doctors saying that pharmacies around the state had begun to refuse to fill prescriptions for controlled substances because the prescriptions were not written on the approved pads. “Allowing the practitioners who are approved to prescribe controlled substances more time to order the prescription pads was necessary to ensure public safety over the long term,” Farmer said. “Now is the time to start using them.”
August 15, 2011
ASAM RELEASES NEW DEFINITION OF ADDICTION
Addiction Is a Chronic Brain Disease, Not Just Bad Behaviors or Bad Choices
CHEVY CHASE, MD, August 15, 2011 – The American Society of Addiction Medicine (ASAM) has
released a new definition of addiction highlighting that addiction is a chronic brain disorder and not
simply a behavioral problem involving too much alcohol, drugs, gambling or sex. This the first time
ASAM has taken an official position that addiction is not solely related to problematic substance use.
When people see compulsive and damaging behaviors in friends or family members—or public
figures such as celebrities or politicians—they often focus only on the substance use or behaviors as the
problem. However, these outward behaviors are actually manifestations of an underlying disease that
involves various areas of the brain, according to the new definition by ASAM, the nation’s largest
professional society of physicians dedicated to treating and preventing addiction.
“At its core, addiction isn’t just a social problem or a moral problem or a criminal problem. It’s a
brain problem whose behaviors manifest in all these other areas,” said Dr. Michael Miller, past president
of ASAM who oversaw the development of the new definition. “Many behaviors driven by addiction are
real problems and sometimes criminal acts. But the disease is about brains, not drugs. It’s about
underlying neurology, not outward actions.”
The new definition resulted from an intensive, four‐year process with more than 80 experts
actively working on it, including top addiction authorities, addiction medicine clinicians and leading
neuroscience researchers from across the country. The full governing board of ASAM and chapter
presidents from many states took part, and there was extensive dialogue with research and policy
colleagues in both the private and public sectors.
The new definition also describes addiction as a primary disease, meaning that it’s not the result
of other causes such as emotional or psychiatric problems. Addiction is also recognized as a chronic
disease, like cardiovascular disease or diabetes, so it must be treated, managed and monitored over a
Two decades of advancements in neurosciences convinced ASAM that addiction needed to be
redefined by what’s going on in the brain. Research shows that the disease of addiction affects
neurotransmission and interactions within reward circuitry of the brain, leading to addictive behaviors
that supplant healthy behaviors, while memories of previous experiences with food, sex, alcohol and
other drugs trigger craving and renewal of addictive behaviors. Meanwhile, brain circuitry that governs
impulse control and judgment is also altered in this disease, resulting in the dysfunctional pursuit of
rewards such as alcohol and other drugs. This area of the brain is still developing during teen‐age years,
which may be why early exposure to alcohol and drugs is related to greater likelihood of addiction later
There is longstanding controversy over whether people with addiction have choice over antisocial
and dangerous behaviors, said Dr. Raju Hajela, past president of the Canadian Society of Addiction
Medicine and chair of the ASAM committee on the new definition. He stated that “the disease creates
distortions in thinking, feelings and perceptions, which drive people to behave in ways that are not
understandable to others around them. Simply put, addiction is not a choice. Addictive behaviors are a
manifestation of the disease, not a cause.”
“Choice still plays an important role in getting help. While the neurobiology of choice may not
be fully understood, a person with addiction must make choices for a healthier life in order to enter
treatment and recovery. Because there is no pill which alone can cure addiction, choosing recovery over
unhealthy behaviors is necessary,” Hajela said.
“Many chronic diseases require behavioral choices, such as people with heart disease choosing
to eat healthier or begin exercising, in addition to medical or surgical interventions,” said Dr. Miller. “So,
we have to stop moralizing, blaming, controlling or smirking at the person with the disease of addiction,
and start creating opportunities for individuals and families to get help and providing assistance in
choosing proper treatment.”
To read the full Definition of Addiction, visit:
Dr. Miller is past president of ASAM. Dr. Hajela is past president of the Canadian Society of Addiction
Medicine and is a board member of ASAM. The American Society for Addiction Medicine is a professional
society representing close to 3,000 physicians dedicated to increasing access and improving quality of
addiction treatment, educating physicians and the public, supporting research and prevention, and
promoting the appropriate role of physicians in the care of patients with addictions.
American Society of Addiction Medicine
4601 North Parke Avenue, Upper Arcade, Suite 101 Chevy Chase, MD 20815‐4520
Phone (301) 656‐3920 ● Fax 301‐656‐3815 ● Web www.asam.org