By Bill Thompson
As his family recalled him, Corey Langdale loved dirt bikes, fishing, mud-bogging in his massive red Ford pickup, tailgating at Florida Gator games and easily befriended people with his sense of humor.
Yet a demon that had gotten hold of the 24-year-old Ocalan caused his untimely demise. Langdale died 18 months ago from an accidental overdose of prescription medications.
Now his mother, Karen Ellis, wants to exorcise the evil before other parents face what she had to go through and burying a child too early.
Yet she worries that while a useful tool is in place to avert a tragedy for other families, the resources might not be there to sustain it.
Ellis, an Ocala Realtor and member the Florida Prescription Drug Monitoring Program Foundation board, is raising awareness of a new bill from state Rep. Mike Fasano, who seeks changes that affect the dispensing of prescription drugs within Florida.
Primarily, Fasano, a New Port Richey Republican, is looking to expand funding sources for the state’s prescription-monitoring database, known formally as the Electronic-Florida Online Reporting of Controlled Substances Evaluation program, or E-FORCSE.
“It was more painful for me than I anticipated,” Ellis recalled in a recent interview about becoming an activist and trying to reduce the number of deaths attributable to prescription medications.
“But I just started reading about the numbers in Florida. We have to do something. We cannot accept the state of Florida having seven deaths a day.”
In 2011, the most recent year for which statistics are available, 2,539 people — or seven a day — died with at least one prescription drug in their system that was identified as the cause of death, according to the state Medical Examiners Commission’s annual report on drug-related deaths.
The commission notes that these drugs were either the direct cause of death or worked in conjunction with other medications, illegal drugs or alcohol.
The number was actually good news.
Deaths in 2011 attributable to a fatal amount of prescription medications dropped by 6.4 percent relative to 2010, the MEC report notes.
And the number of those who, like Langdale, accidentally overdosed on a prescription drug fell by 11 percent.
While the death rate of some types of painkillers and tranquilizers was up from the previous year, the MEC observed positive trends among some of the best-known prescription drugs.
The commission defines an “occurrence” as identifying a specific drug within a decedent’s system.
In 2011, compared with the prior year, occurrences of Xanax fell by 14.3 percent, Valium dipped 1.7 percent and oxycodone dropped 11 percent.
Fatalities specifically caused by oxycodone, which Florida officials feared not so long ago was killing people at an epidemic rate, plummeted even more dramatically, down by 18 percent in 2011.
Still, on the down side, the commission pointed out that prescription drugs were discovered in the deceased more often than illegal drugs in 2011.
Ellis said her story was familiar among those she has heard from other parents.
Corey Langdale was a former football player at Belleview High School who got in trouble with marijuana after high school.
State records show that in July 2005 he was arrested for marijuana possession and grand theft. In April 2007 he was sentenced to 22 months in prison.
Ellis said he got out and rebuilt his life.
But his downward spiral from sobriety began about four months before he died, when he found prescription medications to feed his habit.
“You take away their keys. You take away their cellphones. You take away their computer. And you think you’ve stopped them from getting it,” Ellis said.
But, she added, “If they want to get their hands on it, they’re going to get it. It’s easy.”
She eventually landed a seat on the board of the Florida Prescription Drug Monitoring Program Foundation, a nonprofit created by the original 2009 anti-doctor-shopping law to help the Department of Health manage the database.
The initial effort to crush pill mills was overwhelming.
The original bill, a version of which was championed by former GOP state Rep. Kurt Kelly of Ocala, passed the state Senate unanimously and had only 10 opponents in the 120-member House.
Through the law, the foundation was empowered to help administer and maintain the database as well as conduct studies to gauge the program’s effectiveness, provide funding for future enhancements and inform the public, doctors and pharmacists about the database via public education campaigns and training workshops.
Yet lawmakers also barred the state from financially assisting in accomplishing all of that — leaving federal and private funding as the program’s only revenue source.
In 2011, the database took another hit when Gov. Rick Scott and some state lawmakers refused to budge on allowing drugmakers to fund the database, thus killing a $1 million offer to do that by Purdue Pharma, the maker of OxyContin.
Despite that, the database finally got off the ground in September 2011. It still struggles, however.
Rep. Fasano, who as a state senator proposed the 2009 bill creating the program, has proposed several key changes.
For example, Fasano’s bill contains a new provision requiring doctors or their designees to check the database before prescribing drugs to new patients, or face a penalty if they don’t.
The measure would also to prohibit non-doctors from owning pain management clinics, the primary source for Florida’s reputation as the pill mill capital of the U.S.
Fasano’s legislation also mandates that clinics owned by big corporations register with the state.
Perhaps most importantly, Fasano wants the state and drug companies to help shoulder the costs for the database. His bill specifically strikes provisions that bar them as funding sources.
Ellis believes the effort to upend pill mills is working, and some evidence suggests that.
The 2009 bill establishing the database noted that nine Floridians a day were dying with prescription drugs in their systems. That has dropped to seven.
But the foundation drastically needs help to continue, Ellis said.
Specifically, about $500,000 in help — the amount necessary to operate the database on a yearly basis.
The funding problem could be resolved, she said, by charging those who prescribe and dispense medications a small fee — perhaps $10 or $20 — each time they renew their licenses.
Florida has 104,276 prescribers and another 27,260 dispensers, according to Ellis.
According to the Alliance of States with Prescription Monitoring Programs, Missouri is the only state that has not launched such a program or passed legislation to implement one.
Florida, however, is one of the biggest ones that refuses to publicly fund it.
Ellis said that needs to change.
“A lot of parents approach me and tell me what they’re going through with their kid because I’m an example of what not to do. My eyes have been opened,” said Ellis.
“We are all affected by this. And we really need better systems in place, like the monitoring program. We’ve got to step up to the plate somehow.”
Contact Bill Thompson at 867-4117 or at bill.thompson@starbanner.com.
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Guest Article: Fight Prescription Drug Abuse
By Dave Bowen
One pill can kill.
Prescription drug abuse is the most threatening substance abuse issue in the State of Florida. According to the 2010 Florida Medical Examiners Commission Report on Drugs Identified in Deceased Persons, prescription medications such as Benzodiazepines and Oxycodone, Methadone, Morphine and Hydrocodone caused the most deaths of drugs tracked by this report. The report also identified that 2,710 of the individuals died with at least one prescription drug in their system that was identified as the cause of death.
Florida is widely recognized as “ground zero” for what has become a national prescription drug abuse epidemic, with states as far as Maine suffering the consequences of the overprescribing of prescription drugs in Florida.
Florida accounts for 89 percent of all the Oxycodone sold nationwide last year. A very high percentage of the access to Oxycodone came from “pill mills,” which are cash-only convenience stores for painkillers, often advertised as pain-management clinics. Not only are drug-seekers flocking to our state, but the illegal operations of these pill mills also impacts legitimate patients in need of specialized treatment from true Pain Management physicians.
In an effort to thwart individuals who “doctor shop” and hop from pharmacy to pharmacy, filling multiple prescriptions for powerful narcotics, the Florida Legislature in 2009 approved the creation of the Prescription Drug Monitoring Program (“PDMP”) database. This initiative encourages safer prescribing of medications and reduces drug abuse and diversion in the state, while complying with federal health-care privacy law. Florida Attorney General Pam Bondi hailed the program as “another step forward in Florida’s fight against prescription drug abuse.”
When tough economic times prohibited state funding for the database, the Legislature authorized fundraising through a Direct Support Organization (“DSO”), leading to the creation of Florida’s PDMP Foundation. The PDMP Foundation board of directors includes a county sheriff, a former director of the Florida Office of Drug Control and representatives from the business community. Having spent the majority of my career in healthcare, I was excited to give back to the citizens of Florida by serving as Florida’s PDMP Foundation chairman.
The PDMP Foundation received nearly $500,000 in start-up contributions. Aegis PainComp Testing Services, Millennium Laboratories and Automated HealthCare Solutions were the top funding sponsors. Citizens and law enforcement agencies have also donated to help start the program. The state received additional funding in grants from the federal government and national groups.
The Foundation used this seed money to launch the statewide monitoring program earlier this year. The online database went live in October, giving Florida physicians and pharmacists access to vital information on patients’ prescription histories. In just the first few weeks of operation, more than 5,000 pharmacies and other dispensing locations have entered more than 18.5 million prescriptions for controlled substances into the database. In addition, 4,800 health care practitioners have reviewed patient information in the database. This launch has been the most successful that I know of in the nation, due largely to the support it has received under the leadership of Florida Surgeon General Dr. Frank Farmer and the tireless work of Rebecca Poston, Program Manager and Erika Marshal, Program Operations Administrator.
When U.S. Attorney General Eric Holder visited Tampa in late October to speak about Florida’s prescription drug crisis, he noted that Florida, for too long a source of the problem, is now becoming part of the solution, thanks in part to the Prescription Drug Monitoring Program. Holder hailed monitoring programs as among the most effective tools to curb doctor shopping.
Not all of us have had addiction or drug abuse affect our lives that closely. You may ask, “Why should I care about an issue like this?” Whether we like it or not, prescription drug abuse has a far-reaching impact on our communities, and it touches us all in a variety of ways. Two professors at the University of South Florida in Tampa highlighted one of those alarming ripple effects earlier this month: Florida leads the nation in the number of newborns addicted to prescription drugs because of their mothers’ drug use.
The researchers said in a recent editorial for the St. Pete Times that the number of these addicted newborns has nearly quadrupled in Florida during the past five years. The mothers’ drug use increases the risk of slower weight gain and sudden infant death syndrome for these babies.
The news among teens isn’t much better. Prescription drugs have become the second-most abused illegal drug, behind marijuana, among 12- to 17-year-olds, according to the Florida Office of Drug Control. These young people represent our future. We cannot sit idly by and let prescription drug abuse ruin their potential. They won’t be the only ones who are hurt. We all suffer when so many are left behind.
The good news is we have the technology to attack the problem. Doctors and hospitals across the country are embracing electronic medical records as a means to deliver higher quality care at lower costs. Florida’s new prescription drug monitoring program is a wonderful complement to those technological innovations in medicine. The database offers benefits to doctors and patients beyond just preventing the spread of prescription drug abuse. It can help save patients’ lives and improve the quality of care.
For instance, physicians can use the database to carefully review the various medications that are prescribed to an elderly patient. This is a critical issue in a state with so many retirees who have substantial health-care needs. Doctors can use the database to ensure new prescriptions don’t pose dangerous interactions with other medications that already are being taken.
This also can help doctors reduce excess prescriptions that end up sitting unused in medicine cabinets across the state. These leftover pills are one of the biggest sources of diverted drugs. Enough painkillers were prescribed in 2010 to medicate every American adult for 24 hours a day for one full month, according to the Centers for Disease Control and Prevention. Studies show that the majority of teens who abuse prescription drugs get them from family and friends for free, often from the home medicine cabinet.
Consider what Americans turned in last month (OCT 29) during the National Prescription Drug Take-Back Day. The U.S. Drug Enforcement Administration collected more than 188 tons of unwanted or expired medications at 5,300 sites across the United States. That helps remove a major source of drugs. But the bad guys aren’t going away, so we can’t get complacent or think our work here is done.
Despite the recent federal crackdown against questionable pain clinics and unscrupulous doctors, officials have still seen a dramatic increase in the number of new pharmacy applications. Law enforcement officials say many of them are likely pill mills that should be denied.
The Florida PDMP is a big step in combating the scourge of prescription drug abuse in our state. But more resources are needed to continue the initiative. The Foundation has set an annual fundraising goal of $750,000 to help keep this crucial database running.
Please consider helping our foundation raise the funds necessary to operate a highly effective prescription drug monitoring program and database. We’ve already sent a powerful message that we won’t tolerate the status quo. It’s imperative we keep our momentum going and find the resources for the battles ahead.
For more information on donating to the Florida Prescription Drug Monitoring Program Foundation Inc., go to www.flpdmpfoundation.com or call chairman Dave Bowen at (954) 874-2116.
Dave Bowen is chairman of the Florida PDMP Foundation, Inc., a 501(c)(3), non-profit organization. He also is president of Automated HealthCare Solutions in Miramar, FL.
MIRAMAR, FL –This week Florida launched a powerful new tool to keep patients safe from dangerous drug interactions and fight prescription drug abuse. E-FORCSE, (Electronic Florida Online Reporting of Controlled Substances Evaluation program) went live, giving physicians, pharmacists and dispensers access to the prescription drug history of Florida patients.
TALLAHASSEE, Fla. –Attorney General Pam Bondi today issued the following statement on the launch of the Electronic Florida Online Reporting of Controlled Substances Evaluation program (E-FORCSE), or Florida’s Prescription Drug Monitoring Program.