State governments nationwide soon plan to track electronically Americans' use of commonly prescribed medications for pain, anxiety, attention-deficit disorder and sleep disorders.

On August 11, President Bush signed into law the National All Schedules Prescription Electronic Reporting Act of 2005. It authorizes 60 million taxpayer dollars over five years to establish electronic prescription drug surveillance programs in all 50 states and the District of Columbia. It requires those dispensing controlled substances (such as pharmacists and physicians) to submit information to state governments within one week of filling prescriptions, including patients' names, addresses and telephone numbers. Data also will be collected on animal owners whose pets are prescribed controlled substances by veterinarians.

Congress's stated purpose of the law is to help physicians identify and treat prescription drug addiction and abuse. (According to the National Institute on Drug Abuse, 2.7 percent of the population age 12 and older use prescription drugs for non-medical purposes.) However, the legislation goes much further than its announced intent by also allowing local, state and federal law-enforcement agents to use the nationwide electronic prescription drug data.

How will the new law affect patients and doctors? How will it affect individuals' health privacy? What can citizens do to prevent invasions of their medical privacy?

Government prescription drug monitoring programs could foster mistrust between patients and physicians. Patients logically would be less likely to trust doctors who are required by law to submit information to states. Also, individuals whose pain needs are not being met and who choose to shop around for better pain-management services could be viewed suspiciously by state governments, or wrongly labeled as addicts or criminals. Some may turn to illegal drugs as an alternative to prescription medications.

Under the new tracking systems, physicians could lose autonomy because state agents, rather than individual private physicians, would set medical-prescribing standards. Physicians also could be encouraged to view "doctor shoppers" as potential prescription drug abusers. Yet, in a free society we should be encouraging competition and shopping around for health-care services, like we do in most other areas of our lives.