It's designed to help safeguard Guam from the prescription drug epidemic that's plaguing the U.S. mainland. A new bill would expand the local prescription drug monitoring program, and mandate medical practitioners who prescribe certain controlled substances to register for it.

The bill by Sen. Telena Nelson notes that more than half of all local prescriptions are for opioids, but only 65 of 392 doctors who can prescribe controlled substances are registered to the prescription drug monitoring program database. Public Health's Division of Environmental Health Chief tom Nadeau says they support mandatory prescriber registration.

"This will result in true efficient care and management," he said. "Individual practitioners have a professional, lawful and ethical duty to ensure controlled drugs are prescribed and dispensed in a manner that takes into account the nature of the drug prescribed, the established medical standards for prescribing such drugs, and that there's a legitimate medical purpose for treatment using these drugs."

But Gary Schiff, a patient rights advocate, says the mandate is not necessary. He opposes what he believes is an unnecessary government intrusion into what should be a private matter between patient and physician.

"The prescription drug monitoring program was set up to have the firewall at the pharmacy. If you go into a pharmacy with a schedule 2, 3, 4 or 5 medication, they must by law access your history and see if you're doctor shopping and how many prescriptions, and if they don't do that, they won't be able to continue to order those drugs," he said.

Public Health's Nadeau disagrees.

"It starts with the prescriber, that's usually the physician," he said. "They're the ones that write the prescriptions. So I cant say that this is a responsibility given to the pharmacist alone. I think this should be a whole health care community effort. Everything from the prescriber to the dispenser to the public, law enforcement."

But Schiff believes it's a solution looking for a problem.

"Now I also believe strongly that the system we have is working," he said. "I don't see statistics where we see prescription drug abuse on the street, people stealing drugs, overdoses. That's not Guam."

The bill revises a previous measure introduced by Nelson in 2020.