For many people with chronic pain due to cancer and other reasons, fentanyl is a godsend. Commonly used in gel form within a patch attached to the skin, the drug is known to relieve pain when most other painkillers cannot.

The evil side of fentanyl is seen with the alarming growth of criminal activity behind its abused use. Over the past year, the use of Fentanyl to get a heroin like high is increasing as evidenced by the headlines across the country. Combine this with increased amounts of Fentanyl theft and recent recalls of the patches due to possible manufacturing problems and you’re left wondering “what’s the deal with fentaynl?”

The media is headlining the problem with increasing repetition:

• In North Carolina Matthew Chapman died in his sleep…. The 17-year-old had stolen patches of the powerful painkiller fentanyl and placed one on each arm.
• A Minneapolis hospital suspended a nurse for tampering with its stock of fentanyl. The nurse would open new vials of fentanyl, withdraw the contents and replace it with sterile saline solution. The employee self-administered fentanyl later.
• A year and half after Billy Joe Towle Jr. slumped to the floor in his parents’ Detroit area basement [due to the use of fentanyl abuse], a River Rouge drug dealer called Snoop has been charged with supplying at least part of the lethal concoction in the needle that fell from his arm.
• Two drugmakers recently recalled their fentanyl transdermal patches due to concerns that the pain medicine contained in the patch could leak into the packaging.
• Actavis announced a voluntary recall of 14 lots of 25 and 100 mcg/hour patches because of identification of a possible fold-over flaw that potentially could cause the fentanyl gel to leak.

It has been reported that the Centers for Disease Control and Prevention has said there is a surge in fentanyl related abuse and death and the drug is 50 times more potent than heroin when taken intravenously.

It’s obvious fentanyl is a strong temptation to those who would abuse it, and perhaps it is too easily available. There are those who would say the benefits far out way the abuses of a drug like fentanyl, but as Gordon Gibb points out on LawyersandSettlements.com, drug manufacturers should look for ways to avoid potential abuse of its products.

“It should be noted that the Duragesic fentanyl patch has been described as ‘a gift’ for whom the drug is designed and appropriately prescribed—and that a manufacturer cannot be blamed for the wonton disregard for the law, or safe usage demonstrated by criminals.

“However, the oxycontin debacle of last year serves as a reminder that when a potent, and potentially lethal product is designed for consumer use (as opposed to confinement within a controlled environment, such as a hospital), a manufacturer is wise to be aware of the potential for misuse.

“Misuse that could result in serious injury, or even death.”

 Britney Spears and George Clooney Records Breached by Insiders

You have probably heard about the recent experience Britney Spears and George Clooney had when their personal medical records were illegally viewed by hospital personnel.

Clooney was in a motorcycle accident that put him and his girlfriend in the Palisades Medical Center in New Jersey for a day. Some of the hospital personnel went through his personal medical records without authorization and were later suspended for doing so.

Spears was admitted to UCLA Medical Center for a mental evaluation where, like Clooney, her medical records were also illegally viewed by hospital staff. Nineteen employees were either fired, suspended or disciplined.

Unrelated to celebrity medical records, but a similarly disturbing breach of privacy, employees of the U.S. State Department viewed the private passport files of Hillary Clinton, Barack Obama, and John McCain.

But, let’s stick with medical records for now.

You would think basic common sense would dictate that going through someone’s private personal medical records, unless you specifically had a need in the direct healthcare of that person, is just wrong.

The fact of the matter is that so many people and institutions have access to medical records that the U.S. government rightfully instituted the Health Insurance Portability and Accountability Act (HIPAA). This act ensures the privacy of personal medical records by making it basically illegal to view a person’s medical records without strict authorization—a need to know only policy.

The recent medical record fiascos behind the hospital stays of Spears and Clooney bring to the forefront two seemingly opposing dynamics—the public’s insatiable appetite to know every detail of every second of popular celebrities’ lives, and the right of every U.S. citizen to the privacy of their medical records provided for by HIPAA.

Privacy is an important right of American life. Though some privacy laws may slightly differ for those in the public limelight, other important aspects of privacy, like medical records, are just as important for high-profile Americans as for every-day citizens.

What is disturbing is how many of these “peeps and snoops” of celebrity medical records come from within the organizations where healthcare was given—where HIPAA compliance and privacy should be a daily given among healthcare professionals and personnel.

According to the Los Angeles Times account of Spears’ experience, the hospital seemingly did everything it could to keep not only Spears’ records private, but all patient records private in accordance with HIPAA rules. Each hospital employee signs a statement pledging to adhere to confidentiality rules when they are hired; they are trained to know and understand HIPAA guidelines; passwords or PIN numbers are required to access records to monitor who is looking at records and for how long; and when necessary disciplining employees when rules are breached.

In fact, the morning Spears was to come into the hospital, a memo (that did not specifically name Spears) was issued reminding people of their responsibilities to keep patient records and information private.

The memo by chief compliance and privacy officer Carole A. Klove said (taken from Los Angeles Times), “Each member of our workforce, which includes our physicians, faculty, employees, volunteers and students, is responsible to ensure that medical information is only accessed as required for treatment, for facilitating payment of a claim or for supporting our healthcare operations. Please remember that any unauthorized access by a workforce member will be subject to disciplinary action, which could include termination.”

Even with all of that more than 20 unauthorized people viewed Spears’ records compromising her medical privacy, breaching security systems, and blatantly disregarding hospital expectations and their own sense of right and wrong.

The bottom line is that all of the hospital and government regulations, training and discipline can’t stop individuals from looking at private medical records. They help create expectations, provide training and guidance, and action when rules are broken, but it will always come down to individuals simply respecting others private information as if it were their own.

This week’s Google announcement of a secure online portal they are piloting that will allow consumers to save their personal medical records and allow Internet access to anyone they authorize, has sparked a growing privacy (or the lack of) concern.

The whole idea of the portals is to give more control of health-related information to patients and also to (hopefully) lower overall health care costs. But, while many consumers may feel their personal records placed on the portal are federally protected by HIPAA, in reality their privacy may end up compromised.

HIPAA only provides protection in three types of institutions: medical care providers such as hospitals and physicians, health insurance companies, and medical records clearing houses. If a consumer pulls their medical records and gives them to a non-HIPAA covered entity or person, they lose their HIPAA privacy protections.

Google is partnering with The Cleveland Clinic to pilot the program where up to 10,000 patients may voluntarily share their medical information such as prescriptions, conditions and allergies between the clinic and an online Google profile. Last October, Microsoft announced its HealthVault, a similar service.

Google is taking the more appropriate course of conducting a significant pilot program to test whether personal health record portals do what they are intended to do. This should iron out many of the privacy concerns. Microsoft, while enjoying first-to-market success, has released HealthVault to the early adopter market and may have to address privacy by trial and error that could leave subscribers open to privacy vulnerabilities.

Wall Street Journal, Google Blog, Reuters, SC Magazine, Associated Press, MedHeadlines, MediConnect Blog, MediConnect Global