In August 1970 the New York Legislature created a special commission to evaluate the State’s drug-control laws after determining that drugs with both legitimate and illegitimate uses were being diverted into unlawful channels. The commission found existing laws deficient because there was no effective way to prevent stolen or revised prescriptions, repeated refills by unscrupulous pharmacists, patients obtaining prescriptions from multiple doctors, or doctors over-prescribing.
The 1972 New York State Controlled Substances Act classified potentially harmful drugs into five schedules and placed the most dangerous legitimate drugs, including opium derivatives, cocaine, methadone, amphetamines, and methaqualone, in Schedule II. With an exception for emergencies, the Act requires every Schedule II prescription to be written in triplicate on an official form that identifies the prescribing physician, the dispensing pharmacy, the drug and dosage, and the patient’s name, address, and age; one copy must be forwarded to the New York State Department of Health in Albany.
Approximately 100,000 Schedule II prescription forms arrive at the Department of Health each month, where they are sorted, coded, logged, and recorded on magnetic tapes for computer processing before being returned to a vault for five-year retention and eventual destruction. The receiving room is protected by a locked wire fence and alarm system, computer tapes are stored in a locked cabinet, the computer runs off-line with no external terminals, and public disclosure of patient identities is prohibited by statute and regulation with willful violations punishable by up to one year in prison and a $2,000 fine.
At the time of trial, seventeen Department of Health employees had access to the files. Twenty-four investigators were authorized to investigate cases of apparent overuse. After twenty months of operation the computerized data had been used in only two investigations. A few days before the Act became effective, patients who regularly received Schedule II prescriptions, doctors who prescribed such drugs, and two physicians’ associations commenced this litigation challenging the patient-identification provisions.
After an initial dismissal that was reversed by the Court of Appeals for the Second Circuit, a three-judge District Court conducted a one-day trial. Appellees introduced evidence that some patients declined needed Schedule II medication because of fear that the computerized records would stigmatize them as drug addicts. Two parents had taken a child off such medication for that reason. Three adult patients feared disclosure, with one now obtaining drugs out of state.
Four physicians testified that patients reacted with shock and concern when informed of the central filing system and that one doctor had stopped prescribing Schedule II drugs altogether, although more than 100,000 such prescriptions continued to be filled each month without reported objections reaching the District Court. The District Court enjoined enforcement of the patient-identification provisions of the Act.
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