Pharmageddon: A Statutory Solution to Curb Ohio's Prescription Abuse Problem
Woodworth, Ed, Journal of Law and Health
I. INTRODUCTION II. BACKGROUND A. Dangers of Prescription Drug Abuse 1. Opioids 2. Tranquilizers 3. Stimulants B. Costs of Prescription Abuse C. Reasons for Prescription Drug Abuse D. Sources of Prescription Drugs Used for Abuse 1. Pill Mills 2. Doctor Shopping 3. The Home E. Current State of Federal Law: Controlled Substances Act F. Current State of Ohio Law vis-a-vis Prescription Reporting III. ARGUMENT A Core Competencies of House Bill 93 and Medical Rule 4731-11-11 1. House Bill 93 Makes It Difficult to Operate Pill Mills in Ohio 2. The Recent changes Also Enable Easier Access to oARRS B. Shortcomings of H.B. 93 and Rule 4731-11-11 1. Technical Issues with Ohio's Current Law 2. Reactive C. Proposed Solution 1. Mandatory OARRS Monitoring 2. Interstate OARRS Connectivity 3. Unused Prescription Collections 4. Anti-Doctor Shopper Statute D Debunking the Criticism of OARRS by Practitioners and Patients IV. CONCLUSION
Portsmouth, Ohio is a small steel town with a big city problem. (1) This city has been particularly hard hit by the prescription drug abuse epidemic. (2) Nationally, the prescription abuse epidemic has killed more people than the crack cocaine epidemic of the 1980's and the heroin epidemic of the 1970's combined (3) In 2010, "9.7 million doses of prescription painkillers were dispensed in Scioto County[, Ohio, or] 123 doses for each of the 79,000 men, women and children in the county." (4) Portsmouth counts its dead by lining the front window of a vacant department store with pictures of those who died due to overdosing. (5) The city is essentially raising third and fourth generation prescription drug addicts. (6) In one particularly disheartening instance, a local family could name eleven houses on their street that sold drugs. (7) The majority of people who abuse these medications either get their drugs from dealers on the street or from someone who has access to these drugs. (8) The drug of choice--Oxycontin--is legal, and can be obtained from a local pharmacy with a prescription. (9) Drug abuse there is so pervasive that, despite the high unemployment rate, (10) some businesses have difficulty finding job candidates who can pass a drug test. (11)
While some parts of Ohio are affected more so than others by this prescription abuse epidemic, (12) current legislation allows a situation, like that of Portsmouth, to happen anywhere in Ohio. This is in large part due to Ohio's statutory scheme that focuses more on punishment than prevention, despite recent encouraging changes that have been made. (13) Despite the changes already in place, the legislature should enact a consequential solution that prevents prescription abuse by removing these drugs from the streets.
Ohio has a system in place with the capability to curb prescription drug abuse, but it is far underutilized. (14) The Ohio Automated Rx Reporting System ("OARRS") currently tracks all controlled prescription medications dispensed by an Ohio-licensed pharmacy. (15) OARRS is "designed to allow physicians and pharmacists to cross-check prescriptions with each other and identify individuals who may be doctor shopping." (16) When using OARRS, physicians can more effectively serve as the gatekeepers to dangerous prescription medications because they have access to more information to make the best decisions regarding prescription choices for patients. (17) But, currently, reporting from the system is not required in all situations, and before the recent changes of 2011, only a minority of practitioners were registered to use it. (18) In response to the growing prescription drug abuse epidemic, the Ohio legislature enacted House Bill 93 on May 20, 2011 (19) to eliminate "pill mills," (20) or a physician's office that sells prescriptions under the table to anyone with cash. (21)
Regardless of the positive effects with the enactment of H. …