February 17, 2011
The Honorable Rick Scott
Governor, The State of Florida
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400 S. Monroe Street
Tallahassee, FL 32399
Dear Governor Scott:
I am alarmed and dismayed by recent press reports indicating your intention to repeal Florida's Prescription Drug Monitoring Program (PDMP). On behalf of my constituents, who continue to suffer from out-of-control and escalating prescription drug diversion originating from your state, I respectfully ask that you reverse your position on the value of and unquestionable need for Florida's PDMP and go to work on implementing this important medical and law enforcement solution. The tragic story of Lisa Rogers as reported on February 14, 2011 in the St. Petersburg Times is one of many heart-wrenching incidents in my congressional district that have occurred as a direct result of the illicit diversion of prescription narcotics from Florida to Appalachian Kentucky, and frankly, along the entire eastern seaboard. Dubbed the "Flamingo Road," thousands of unscrupulous drug dealers and addicted users have made the trek to your state because of the ease of access to these powerful and habit-forming drugs, and after years of prodding, your predecessor acknowledged the need for action. A giant sigh of relief swept across the nation when S.B. 462 was signed into law in Gainsville. Now is not the time to back down from this life or death challenge.
The Office of National Drug Control Policy has indicated that the abuse and misuse of prescription drugs is our country's fastest growing drug problem, and your state is ground zero for black market painkillers that continue to spawn overdoses and feed illegal habits across the country. Notably in 2009, 98 of the top 100 prescribers of oxycodone hailed from Florida, dispensing over 19 million dosage units of this drug, which represents 89% of the total dispensed by the country's top prescribers. While Kentucky leads the nation in the non-medical use of prescription drugs, overdoses are killing seven Floridians per day. The notion of cancelling Florida's PDMP is equal to firing firefighters while your house is ablaze; it neither makes sense nor addresses an urgent crisis. Governor, your state, more than any other, must take this crisis seriously.
As we've seen in Kentucky, PDMPs are one of the most effective and accessible tools to combat prescription drug diversion and abuse, bridging the gap between legitimate medical need and potential misuse. The Kentucky All Schedule Prescription Electronic Reporting System (KASPER), after which your program is modeled, has had unprecedented success in bringing this problem under control. In 2008, KASPER processed nearly 418,000 requests for patient prescription information. Of the 94% which came from the medical community, including physicians, ER doctors and pharmacists, nearly three-quarters of them say KASPER is "important" in helping to ascertain patient intentions and patterns, and to feel comfortable writing prescriptions for patients truly in need of medical attention. In the same year, just over 11,000 KASPER requests came from the law enforcement community, and 96% of these KASPER users agree that the PDMP is an excellent tool for obtaining evidence in criminal investigations.
These reports create informed decision-making for good medicine and good law enforcement. I have heard anecdotally of countless occasions where KASPER has helped a doctor provide better patient care or a law enforcement official interrupt a crime. Thirty-three other states are catching on with operational PDMPs. Still ten others, Florida included, have passed authorizing legislation. Nationwide, since 2003, there has been a 2,596% increase in the number of prescription reports produced by state-run PDMPs annually. Important steps have recently been undertaken to facilitate interstate data exchange among these programs to reduce the doctor shopping we're experiencing, such as that between Florida and Kentucky. With such impressive strides being made to enhance the PDMP model and integrate data-sharing, now is not the time to back away from project implementation in Florida. Your state's participation is paramount to the success of our nation in fighting this problem, helping addicts get treatment and prosecuting pushers.
Some have wrongly suggested that patient privacy could be compromised and have used this as an unfounded distraction. Every existing PDMP has strict state and federal regulations governing who may access the data system and for what purpose. Florida is no different. Violators of these laws are charged in criminal courts as Class C or Class D felons, and medical practitioners face the loss of their license. In most instances, only medical licensing boards, law enforcement officers, Medicaid, grand juries with a subpoena, practitioners, pharmacists and judges and/or parole officers are granted access to patient information. Many states have even stricter regulations governing access to prescription drug information.
Finally, as Chairman of the House Appropriations Committee, I can certainly appreciate the fiscal pressures with which you are confronted in balancing a tight state budget. However, this is a matter which warrants sacrifices elsewhere. The U.S. Department of Justice has already invested $800,000 to stand up Florida's program. Surely we can agree that to squander this important investment in your PDMP, which I understand has been complemented by some $500,000 in private donations, during such dire economic times would be imprudent.
Governor Scott, President Obama's Drug Czar and former Seattle police chief Gil Kerlikowske will tour Kentucky next week to survey the Commonwealth's enormous troubles with prescription drug abuse. I can tell you that he will find that our problems begin in the Sunshine State. I strongly encourage you to see through the implementation of Florida's PDMP and not turn your back on the coalition of Florida police officers, physicians, pharmacists, treatment professionals, and even legitimate pain management clinics who have fought tirelessly in search of a solution.
Member of Congress