John Locke Foundation – North Carolina Keeps Tabs on Your Prescriptions
October 01, 2010
This week’s “Daily Journal” guest columnist is Daren Bakst, John Locke Foundation Director of Legal and Regulatory Studies.
RALEIGH — A neighbor takes pain medicine to relieve the suffering from chemotherapy. A child takes Ritalin to address attention deficit disorder. A good friend takes medication to assist in the treatment of mental illness.
All of these individuals have something in common besides illness: North Carolina government officials have their private prescription records.
Recently, there was outrage over a proposal by the state sheriffs’ association that would allow sheriffs to have access to individual prescription information regarding painkillers and controlled substances.
While this outrage is justified, it misses an even bigger point. North Carolina government officials already have access to this information. The N.C. Department of Health and Human Services collects this information from retail pharmacies and puts it into a massive database that currently contains over 53 million prescriptions.
The State Bureau of Investigation can access this database very easily — it only has to meet minor hurdles to obtain sensitive private health information.
DHHS reviews the database, and if it identifies patterns of drug misuse and abuse, it’s required to notify the attorney general.
The database is aimed at preventing “doctor shopping,” a practice in which individuals obtain multiple prescriptions for nonmedical reasons. This is a legitimate concern, but it still can’t justify the shotgun approach that North Carolina is taking to address this problem.
The database has been operational since 2007. Since then, based on an informal DHHS estimate, only about 50-60 “red flags” have been raised over patterns of abuse existing in the database. This is a miniscule number given the large number of prescriptions in the database.
To identify abuses of a few, the state wants to violate the privacy of the vast majority of individuals who are not abusing any drugs. Further, those who are abusing painkillers and controlled substances through “doctor shopping” generally are doing so due to addiction, according to the Drug Enforcement Administration.
The public should not have to worry about seeking necessary medical treatment at the expense of giving away sensitive personal information to the state. A trade-off between relieving pain and protecting personal privacy is a choice the public should never have to make.
For illnesses such as depression, there already is a serious problem of patients not seeking proper treatment. As members of the public grow more aware about what the state is doing behind their backs, patients would be even less likely to get the medicine they need.
The privacy violations are made even worse when the state gives this sensitive information to law enforcement without any real safeguards. At a minimum, there will be understandable fear that law enforcement officials will be able to scour health records for no other reason that to send people to jail.
Proponents certainly will make a case that such a database helps law enforcement address drug abuse. However, that routine argument could be made for most illegal activities —that’s why we have protection from unreasonable searches and seizures.
Law enforcement officers are always going to seek access to this type of information because it would make their jobs easier. We can give up our rights, or we can properly recognize that freedom should not be sacrificed due to minor improvements in security.
The problems of granting excessive power to law enforcement can easily be seen in light of the recent SBI scandal — the SBI withheld or distorted evidence in about 200 cases that may have helped the defendants. Now imagine that same SBI having your personal prescription information.
The recent scandal should not impose a black eye on all law enforcement. However, it should serve as an important reminder why we need to be wary of giving too much power and information to the state.
When the North Carolina legislature returns in 2011, it should eliminate this database that goes way too far in violating the privacy of many fellow citizens. It should protect citizens from state bureaucrats and stop the snooping of our private health records.
