Many states now have prescription drug monitoring programs (PDMPs) that assist in the screening of controlled substance prescriptions. The programs aggregate dispensing data uploaded by pharmacies and use the resulting database in responding to queries from health professionals who request a patient’s medication history. The programs provide reports listing the controlled substance medications a patient has previously received. The basic idea is to prevent doctor shopping, in which one prescriber or pharmacist is unaware of medications provided to a patient by another prescriber or pharmacist. A recent case from Florida supports the idea that a PDMP report is a starting point, rather than an ending point, in the assessment of a patient’s need for medication.
A motorist was stopped by law enforcement and charged with illegal possession of alprazolam and methadone, which were found in his car. The motorist told the arresting officers that the medications belonged to his girlfriend and that she had prescriptions for them. Evidence showed that the girlfriend and the motorist shared the car and a single set of keys, on which the girlfriend kept a small bottle containing a few doses of her medications. The state and the defense agreed that if the girlfriend had valid prescriptions for the two drugs, then that would be a valid defense to the drug charges.
At the motorist’s trial, the alprazolam prescription was entered into evidence. However, the methadone prescription was not. The defense explained that the pharmacy had closed and the methadone prescription was not available.
During testimony of the investigating detective, the prosecutor introduced into evidence a report from E-FORSCE, the Florida PDMP. The report did not list a methadone prescription for the girlfriend. The prosecutor argued that this report proved the girlfriend did not have a prescription for methadone.
The motorist was convicted, and he appealed.
The Florida Court of Appeal reversed the conviction on the grounds that the E-FORSCE report was hearsay. The hearsay rule prevents the introduction into evidence of secondhand information in the absence of a clear reason justifying reliability of the evidence.
The appellate court said: “We have no doubt that [the detective] relied on the information in the database, but she used the database not as proof of the facts it revealed, but rather as an investigative tool. Law enforcement officers rely on the E-FORSCE database not for the accuracy of the matters reported, but rather as a justification for further inquiry.”
The court continued: “It is one thing to say the information in the database creates a founded suspicion that justifies an investigation, but quite another to say that it is proof of a fact. It is not intended as proof of a fact and law enforcement officers do not rely on it in that way. Yet that is how it was used in this case.”
The result of this case suggests that health professionals who use PDMP reports should consider the information they contain as justification for further inquiry rather than as proof of a fact. A problematic PDMP report should be investigated further. It may contain erroneous data, or there may be an explanation of seemingly inconsistent information.
In using a PDMP report, a health professional is performing a function designed to prevent illegal prescription drug diversion. This function is done in collaboration with law enforcement. The rules applicable to law enforcement should be applied within this role.
Based on: Hardy v State of Florida, 2014 Fla.App. LEXIS 7172 (May 14, 2014).