States’ efforts to solve the opioid crisis have so far ranged from new criminal laws and penalties to overzealous prosecution. Now, there’s a new approach: North Carolina’s legislature is mulling ending prescription privacy. If it passed, the bill would let law enforcement investigating—just investigating—any drug crime pull their target’s entire prescription history from the state Controlled Substance Reporting System.
Opioids have killed more than 13,000 North Carolinians since 1999 according to Attorney General Josh Stein. There’s a clear trajectory within that period: While 109 people died of overdoses in 1999, at least 1,384 residents overdosed fatally in 2016. Of course, deaths don’t give the full picture: In 2017 alone, more than 15,000 residents received naloxone from emergency medical technicians to reverse overdoses. Stein supports the bill.
The prescription-access bill contains very few safeguards against abuse. All that’s required is that there be an open investigation; if there’s an active case, investigators can get an individual’s entire prescription history. We already have a procedure that’s responsive to law enforcement’s need to build criminal cases and the Constitution both: It’s called applying for a warrant.
The Fourth Amendment contains the phrase “probable cause.” That’s the standard the government has to meet before invading someone’s privacy. Probable cause isn’t that high a standard if you have a decent case: You just need credible information establishing a search is likely to yield proof of wrongdoing. What legislators are proposing would bypass the Fourth Amendment or, at a minimum, provide an unconstitutional shortcut.
Violating privacy’s not going to help. It’ll just scare off prospective patients worried about confidentiality, change doctors’ prescribing policies, and create a huge opportunity for abuse of power. Who wants their entire prescription history to be open to law enforcement? What’s birth control or anti-virals got to do with possessing a tiny bit of pot?
When Utah tried something similar, it resulted in a massive breach of privacy and false charges against two members of the state’s largest fire agency.
Stein’s support is curious, especially as he has more promising efforts in the works. He’s suing pharmaceutical companies—he filed the most recent suit, along with five other states, in May. He and states attorney generals in Nevada, Texas, Florida and North Dakota—an odd assemblage if ever there was one—argue that Purdue Pharma, the maker of Oxycontin, used deceptive marketing practices. An earlier suit targets Insys Therapeutics, which pushed a fentanyl-based drug in North Carolina.