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KOK Edit: your favorite copyeditor since 1984(SM) KOK Edit: your favorite copyeditor since 1984(SM) Katharine O'Moore Klopf
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Wednesday, April 18, 2007

Do the Feds Know What Meds You Take?

A political blog that I respect—AMERICAblog—has come to a disturbing conclusion after reading a report from ABC News about alleged Virginia Tech shooter Cho Seung-Hui: The U.S. government may have a database showing every prescription drug that you, as an American, have bought.

I don't mind telling people—say, those who are discussing depression—that I take an antidepressant. My husband doesn't mind telling people—say, those who think only children have attention-deficit/hyperactivity disorder (AD/HD) or those who think there's no such thing as AD/HD—that he takes a controlled substance to manage his AD/HD. But that's our choice. It would never be our choice to voluntarily tell the federal government what meds we take.

Here is the paragraph in question, from the third page of the ABC News story:
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.
Does this possibility bother you as much as it bothers me? I want to know how to find out whether there is a federal database. I want to know where it is and who has access to it.


Updated 5:58 p.m.: A little searching on USASearch.gov helped me answer my own wondering, to some extent. From this page, I learned that the Prescription Drug Monitoring Program (PDMP) was created in 2002 by the U.S. Department of Justice Appropriations Act (Public Law 107-77). The legislation set up the PDMP to help individual states set up their own monitoring programs and encourages state programs to share data with one another. The drugs monitored are supposedly just controlled substances, such as the AD/HD meds taken by my husband and one of our sons. The PDMP's goals are (1) to cut down on "inappropriate" (who determines this?) use of controlled substances; (2) to decrease instances of doctor-shopping (going from one physician to the next and using fraud to get the desired meds); and (3) to increase cooperation among federal and state health, regulatory, and law-enforcement agencies.

This chart lists states with drug-monitoring programs. Here is more info, including what drugs are monitored and contact details for states with drug-monitoring programs. Here is what some states do with the info they obtain through their monitoring programs.

What's really important to know is that "disclosure of information [about what prescription drugs you take] under [s]tate [drug-monitoring] laws by providers or dispensers may place those parties in violation of HIPAA," the Health Insurance Portability and Accountability Act of 1996, so you may have some grounds to contest your physician's reporting of your medications to your state's drug-monitoring program. Read this for more information on your privacy rights under HIPAA.

And the ACLU's rundown of what the government is allowed to know about your medications is essential reading.


Updated 5/22/07.



15 comments:

Songbird said...

That is very disturbing!!!!

Katharine said...

Yes! This appears to me to be yet another example of rights that the Bush regime has taken from us. I'm afraid that I'm going to be ranting until the day I die about wrongs perpetrated by Bushco ... because it's going to take that long to set everything right!

Karoli said...

I've known about the controlled substance monitoring for awhile. It's awful. But what I recently discovered is that my purchase of Sudafed for allergy control is also kept in a database.

It's bad enough that I have to produce my full name, address, driver's license and phone number to buy an over-the-counter drug, but to land in a federal database. Utter crap.

I resent the government making it difficult for me to get these PRESCRIBED medications at all, much less tracking me in their godforsaken databases.

Katharine said...

Sudafed! I guess having overstuffed sinuses makes one a criminal.

Karoli, do you know the official name of that database or do you have links? I want to know more about it.

Karoli said...

Hi katharine,

I don't know the official name. I do know that controlled substances are considered such because they are tracked and accounted for. The database I referred to is the same one they use to nail doctors for overprescribing narcotics and the like.

The Sudafed database came about because Sudafed can be distilled to produce meth. So they pulled it off the shelves, put it behind the counter but you don't need a prescription to buy it. You just need to sign for it and give all personal details as well as a photo id.

Or you can buy the fake stuff which doesn't work for me. Grrrrrr.

Bill said...

As a principal with the American Disability Association, several of our staff immediately began discussing how the reporting in this instance was handled, and from this information it appears that we may want to consider taking further action than we'd already contemplated.

It bothered us all that his medical history was wholesale broadcast as it was - and it also occurred to us that this might be a HIPAA violation, but in a broader context, every person with mental illness is affected by knee-jerk reporting of this sort.

Thanks mom for letting this fellow know that we aren't alone in asking these questions, and giving us some others to think on.

-Bill Freeman
American Disability Association

Katharine said...

Bill, I'm honored that you read my blog post. Thanks so much for stopping by.

Will the ADA be making an official statement on reportage in the Virginia Tech case? If so, please let me know when it's posted, because I'd sure like to publicize it on my blog.

Joyful Alternative said...

http://www.salon.com/opinion/greenwald/2007/04/19/prescription_drugs/index.html

Glenn Greenwald's got an interesting take on prescriptions. He didn't even mention the cost of paying the doctor to get the prescription.

Ben said...

I wrote to ABC News, and here's the answer I received:

From : ABCNews Support
Sent : Tuesday, April 24, 2007 2:36 PM
To : Ben Hansen
Subject : Federal Database of Prescription Drug Users?


Hello Ben,

Thank you for contacting us.

Unfortunately we are unable to answer your question. We do read each correspondence and any comments or suggestions are forwarded to the appropriate department.

The best way to find what you're looking for is to make liberal use of the various search engines available.

Thanks for logging on to ABCNews.com.

Regards,

Dustin
ABCNews.com
http://abcnews.go.com/

Original Message From Ben Hansen Follows:
-------------------------

http://www.abcnews.go.com/US/story?id=3048108
Killer's Note: 'You Caused Me to Do This'
April 17, 2007

NED POTTER, DAVID SCHOETZ, RICHARD ESPOSITO, PIERRE THOMAS and the
staff of ABC News write:

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.


A "federal database" of prescription medication use in "the
government's files"???

What is ABC News talking about? Can you verify this? Thank you!

Ben Hansen
Bonkers Institute for Nearly Genuine Research
bonkersinstitute.org

Katharine said...

Thanks, Ben. Translation of ABC's response: We're government lackeys. Oops! We didn't intend to reveal that we know something that you, the ignorant American public, don't know.

Anonymous said...

The ABC story has since been edited (bold mine):

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 him in the governments files on controlled substances. This does not completely rule out prescription drug use, including samples from a physician, drugs obtained through illegal Internet sources, or a gap in computer databases, but the sources say theirs is a reasonably complete search.

(NOTE: Some readers may have inferred from an earlier edition of this story that the federal government keeps a comprehensive record of all prescriptions. The Drug Enforcement Agency says it does track prescriptions of so-called controlled substances — including some mood-altering medications — but not all prescriptions made in the United States.)

Katharine said...

Thanks for the tip, Anon. But in searching the Web, I've come across plenty of individuals whose experiences have led them to believe that though the federal and state databases are supposed to monitor only controlled substances, health care professionals and others with access to it are including information on other prescribed medications that aren't classified as controlled substances. I want to see one or more journalists get access to these databases through the Freedom of Information Act. ABC's edit smells like a coverup to me, possibly done after pressure from government officials.

Henitsirk said...

Hi Katharine,
I used to work for a major California HMO. Controlled substance prescriptions are tracked because 1)people abuse the system to get more medication than they need in order to feed their narcotic addictions (which is also a problem in ERs with patients faking severe pain to get high) and 2)physicians themselves abusing the system to get themselves high. As someone already commented, even OTC medications like Sudafed can be abused or turned into other drugs.

I'd say on the one hand it's probably a good thing to track abuses; on the other hand it's a little scary to think the federal government has a central database of medical information. Though that's something we'd have to be OK with if we moved toward centralized medicine.

As far as HIPAA goes, it's a nice idea to make our medical info private, but it's very difficult in practice. One thing that is happening is insurance companies are no longer using SSN's for ID numbers (while I worked at the HMO I had access to the home addresses and SSNs of all of our members, including prominent dotcom CEO's, not to mention a significant portion of their medical histories. I was just a supervisor, no special clearance required!) But have you ever seen a patient file out on the counter or desk in a doctor's office? Not too private.

Katharine said...

Hi, Henitsirk. Nice to hear from you again.

Yes, I agree that controlled substances should be monitored for the reasons you cite. I just can't stand the thought that the federal government or state governments are abusing drug databases and getting info that they shouldn't have.

Year Zero said...

That's typical U.S. tax dollars hard at work. Monitoring it's innocent civilians.
Now I see why people outside the U.S. regard the country as a "corporate police state".
Pharmacists think you are some intelligent criminal with underworld connections when you go get your ADHD prescription.
Pathetic, the U.S. gov't has scared doctors from prescribing medicine because the doctors don't want to be on some DEA/FBI watch list.

-Year Zero

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