ONE OF THE MOST STARTLING side stories in the Virginia Tech saga came from ABC News which reported yesterday:
“Some news accounts have suggested that Cho had a history of antidepressant use, but senior federal officials tell ABC News that they can find no record of such medication in the government’s files. This does not completely rule out prescription drug use, including samples from a physician, drugs obtained through illegal Internet sources, or a gap in the federal database, but the sources say theirs is a reasonably complete search.”
The story implied that the federal government was spying on what prescription medicines – including antidepressants – American citizens were taking.
Boing Boing readers noticed this too, with one writing, “Somehow I missed the signing into law of NASPER, the National All-Schedules Prescription Electronic Reporting Act of 2005 (assuming the ‘federal database’ referenced is actually the combined databases of states accepting NASPER funding). Unfortunately, as I read subsections (f)(1) and (g) of the Act, it doesn’t seem to allow searches such as this one. Must’ve been a signing statement attached.
BB reader Paul Pellerito wrote:
“The federal drugs database mentioned in your recent post about the VA tech shootings seems to be somewhat flawed; the funding is for states to adopt registries reporting schedules II-V controlled substances (things like ritalin, valium, xanax, adderall, vicodin, and oxycontin) but the most commonly prescribed antidepressants like prozac, lexapro, zoloft, effexor, etc are schedule six and thus not considered controlled substances. My day job is working in a pharmacy in Michigan, and we do not report schedule VI to any state or federal database. Chances are if Cho was on an antidepressant the record would not be in a national database. His pharmacy and his prescription insurance company will know, however. “
THE FEDERAL GOVERNMENT’S CLAIMS
1. What states have prescription monitoring programs?
As of November 2006, 33 states had enacted legislation which required prescription monitoring programs: 25 of those programs are currently operating and 8 are in the start-up phase. The 33 states with Prescription Monitoring Programs and/or enacted legislation are: Alabama, California, Colorado, Connecticut, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Mississippi, Nevada, New Mexico, New York, North Dakota, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Virginia, Vermont, Washington, West Virginia, and Wyoming. Currently, the state of Washington uses their program only for disciplinary purposes, however legislation has been introduced to expand the program statewide.
2. Are other states planning to implement prescription monitoring programs?
Fifteen additional states are in the process of proposing, preparing, or considering legislation. These states include, Alaska, Arizona, Arkansas, Delaware, Florida, Kansas, Maryland, Minnesota, Missouri, Montana, Nebraska, New Jersey, New Hampshire, Oregon, and South Dakota.
3. Has monitoring program data been used to target potential subjects of investigations?
Program officials state that their systems are not used to target possible subjects of an investigation. Investigations using prescription monitoring data regarding healthcare professionals are usually conducted after an official complaint is received. Information from the PMP system is, however, gleaned and examined more closely when blatant abuses are revealed in the data. In addition, states use the data to verify that a problem exists and to determine the extent of the diversion or abuse. The systems are also queried regarding patients that are found to be operating as “doctor shoppers”–one individual visiting numerous doctors and pharmacies to obtain pharmaceutical controlled substances.
4. Is the accessibility to controlled substance prescription data a violation of patient confidentiality?
Every prescription monitoring program provides safeguards to protect patient confidentiality and access to controlled substance prescription information through statutes or regulations. After decades of operation, no program has reported a breach of confidentiality. In addition, those state authorities/officials with access to monitoring program data already have the authority to access the controlled substance information. The data doesn’t generate a case, it simply makes collection of the information easier and less intrusive.
5. Who is authorized to review the data and once the data is collected, what is done with it?
State statute or regulation limits accessibility to the PMP data. It is important to note that PMP program officials are not privy to any additional information than they are already able to receive by virtue of their existing positions and job functions. The only difference is that the monitoring programs provide ready accessibility to prescription information in a more user friendly format. Historically, when investigators needed to review prescription information for both routine pharmacy inspections and case investigations they would have to manually sort through paper copies of prescriptions. The PMP database eliminates this tedious process by requiring the prescription information to be maintained electronically. This allows investigators to obtain pharmacy data from multiple locations without having to visit each and every pharmacy. . .
13. What is NASPER?
On August 11, 2005, President Bush signed into law the National All Schedules Prescription Electronic Reporting Act of 2005. The act creates a grant program for states to create prescription drug monitoring databases and enhance existing ones. . .
14. What are the differences between the Harold Rogers Prescription Drug Monitoring grant Program and NASPER?
The Harold Rogers grant program, housed in the Department of Justice, allows states to establish their own requirements with regard to Schedules monitored, information sharing, and accessibility/availability to the program data. Harold Rogers encourages the sharing of information and prescription data among states. Harold Rogers encourages the submission of Schedules II, II, IV & V. . .
The National All Schedules Prescription Electronic Report Act of 2005 (NASPER), housed within the Department of Health and Human Services (HHS), requires states to meet requirements in order to receive grant funding. NASPER requires states to collect information on Schedules II, III, and IV. Additionally, NASPER requires states to be capable of sharing information and prescription data among states.
http://prorev.com/2007/04/is-federal-government-spying-on-what.htm
