Inquirer Editorial: Need better prescription to stop drug abuse

What a top prosecutor calls "the fastest-growing drug problem" in America isn't about dope dealers on a street corner. It starts inside doctors' offices, clinics, hospital emergency rooms, and at pharmacy counters - where painkillers are acquired by prescription.

The rampant abuse of addictive drugs such as oxycodone and hydrocodone contributes to an overdose epidemic now viewed by federal health officials as the leading U.S. cause of accidental death, and Pennsylvania is high on the list of problem states.

It's a public-health challenge that hasn't gone unnoticed by the state's doctors, who say they're often the victims of "doctor shoppers," who scam them with bogus requests for pain treatment.

At the same time, federal authorities say some rogue physicians participate in prescription scams. In a recent case, a Montgomery County doctor was accused of feeding drugs to a large network of area dope dealers who provided phony patients. The physician denies the allegations.

For their part, physicians have aligned behind a two-pronged approach to dealing with the doctor shoppers, whom they see as a hidden and perhaps more widespread problem than street drug dealing, confronting thousands of medical providers.

Under what might be seen as a physician-heal-thyself approach, the Pennsylvania Medical Society recently unveiled a promising campaign to educate doctors about pill scammers and put them on higher alert.

The "Pills for Ills, Not Thrills" effort offers tips to help physicians flag pill-seeking patients, in addition to suggesting screening methods to separate out patients who are in real pain. As a medical society spokesman notes, the effort could be seen as a way "to combat prescription drug misuse and abuse from the inside out."

Just as important, the medical society has conducted a two-year push to create a much-needed digital early-warning system - in the form of a statewide database of patients being treated with narcotics.

Pennsylvania appears to be an outlier in not having a database that health-care providers can tap to detect patterns of abuse. In the region, New Jersey already has a system in place, and New York is readying rules to implement its recently enacted I-STOP (Internet System for Tracking Over-Prescribing) initiative.

A similar Harrisburg measure stalled in the last legislative session, but there does not appear to be much controversy about the idea, so there is optimism that it will pass. Certainly, access to such a database must be carefully controlled, just as is the case now with other medical data under federal patient-privacy rules.

Nor should law enforcement investigators be able to troll the sensitive data without a court-approved search warrant.

With a strategy of greater public awareness, as well as stronger tools to monitor the use of powerful painkillers, the state's doctors and other health-care providers should be in a better position to aid patients' genuine suffering - while also stemming the rising number of prescription drug overdoses.