Spate of Deaths from Abuse of Prescription Drug in Florida

TALLAHASSEE, Fla. - Facing a grim spate of deaths in Florida due to prescription drug abuse, top state officials on Friday announced they are forming a task force to develop new fraud-fighting strategies.

Lives are being lost,'' said state Attorney General Charlie Crist.We have to do what we can to make sure this new era of drug dealing discontinues.''

Crist, and a half dozen health, law enforcement and drug policy advisers to Gov. Jeb Bush, said the task force will explore short-term and long-range plans for tackling Medicaid fraud, shutting down a black market of prescription drugs, ending addicts' ``doctor shopping'' for powerful painkillers and clamping down on illegal Internet sales of pharmaceuticals.

The idea, officials said, is to take a broad approach to the prescription drug crisis responsible for the estimated five deaths each day in Florida and which is contributing to a costly abuse of the government health care system for the poor.

``It's about taking the bad guys down to protect the good guys,'' said John Agwunobi, secretary of the state's Department of Health.

Aides to the governor say they have ideas for legislative actions, including tougher penalties for doctors who over prescribe the medications and pharmacists who fill them, to take advantage of Medicaid reimbursements. They also are reissuing a call for a new prescription-tracking database, financed with $2 million from a state settlement with Purdue Pharma, the maker of OxyContin and other highly abused pain relievers. The database would allow regulators to track and monitor potential Medicaid abusers.

Harsher penalties and the drug registry are initial proposals that state officials and legislators have offered in response to a South Florida Sun-Sentinel series ``Drugging the Poor'' that found that the state has failed to curb the costly abuse of pain-relief patches, sleeping pills, tranquilizers and other narcotics covered under the state's Medicaid program for low-income Floridians. The Orlando Sentinel also conducted an investigation in October that looked at deaths in Florida due to oxycodone, a key ingredient in OxyContin.

State leaders are meeting with groups such as the Florida Medical Association, which represents more than half the state's doctors, to encourage them to voluntarily upgrade health care workers' training to improve the detection and treatment of prescription drug abuse. Additionally, the officials are talking to Florida medical examiners and state prosecutors about how their investigations of drug deaths should change. And another goal is to improve the communication between health investigators and law enforcement officials.

``Medical examiners are able to identify when a number of overdose deaths can be tied to a single doctor. That will become a trigger to pass that information in a timely fashion (to law enforcement),'' said Jim McDonough, director of Bush's Office Drug Control Policy.

In its four-part series, the Sun-Sentinel found fewer than 3 percent of the state's medical professionals prescribed more than two-thirds of the narcotics and other dangerous drugs dispensed to Medicaid patients in the past three years. These drugs cost taxpayers more than $346 million, helped feed a black market of drugs and may have contributed to cases of fatal overdoses.

Many of the doctors who handed out the most Medicaid prescriptions, the investigation found, also are linked to multiple drug-related deaths, or have histories of professional misconduct and even, in a few cases, criminal arrests.

The series identified millions of dollars in suspect pharmacy billings for drugs such as painkillers and sedatives, including claims paid using the billing numbers of doctors who were dead or ineligible to write prescriptions.

Despite the problems in the state outlined in the special report, McDonough said Friday that Florida leaders have been working to address prescription drug abuse problems for some time and may be leading other states in controlling them. I believe Florida is ahead of the game,'' he said.We've been looking at this for a couple of years.''

But Crist acknowledged more needs to be done.

``Law enforcement has done an extraordinary job of stopping the flow of illegal drugs, but this flow of legal drugs for illicit purposes is something we are scratching at the surface of, and we want to do everything we can to stop it,'' Crist said.

The task force that will study and monitor new drug-abuse strategies has not yet been named, but leaders said it will likely include: Crist, Agwunobi, Agency for Health Care Administration Secretary Rhonda Medows and Florida Department of Law Enforcement Secretary Guy Tunnell.McDonough said public interest in the prescription drug abuse has heightened as a result of radio talk show host Rush Limbaugh's admission in October of having been addicted to painkillers. The governor has also made the issue a priority in his administration after his 26-year-old daughter, Noelle, completed a drug rehabilitation program. She was arrested last year at a Tallahassee pharmacy after posing as a doctor to call in a phony prescription for an anti-anxiety medication.

Both the increased public interest and stepped up efforts in state government, McDonough said, may also encourage medical regulatory boards to step up their efforts to take the crimes more seriously. Health officials said that an indication of the emerging interest is the disciplinary action taken last week by the Florida Board of Medicine against eight health workers, including Fort Lauderdale physician William A. Morris III.

Morris received a $20,000 fine and was ordered to do 50 hours of community service after he was found to have been prescribing drugs over the Internet for seven months, earning between $6,000 and $8,000 profit.

Maureen Doherty, a spokeswoman for the Department of Health, said doctors are, by department rule, not allowed to prescribe medicines to anyone they have not already examined in person. Violation of the rule is now a misdemeanor and is identified as ``below the standard of care.'' Health officials want the Legislature next spring to make the practice a felony.

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(c) 2003 South Florida Sun-Sentinel. Distributed by Knight Ridder/Tribune News Service.