Forty-nine states have created databases to track drug prescriptions. This is sensitive information that law enforcement should need a warrant to get its hands on—but the federal government doesn’t agree.

Records of the prescription medications we take can reveal some of the most private and sensitive information about us. Knowing that a person self-administers prescription testosterone injections can reveal that he is a transgender man undergoing hormone replacement therapy. Knowing that someone takes Xanax, Valium, or other anti-anxiety medications can reveal a diagnosis of mental illness. If a person is on Marinol, a medication containing synthetic THC, they may be fighting weight loss associated with HIV/AIDS. A prescription for a narcotic painkiller such as codeine or oxycodone might indicate a chronic or terminal illness. Knowing a person takes Ritalin or Adderall could be associated with treatment of attention deficit hyperactivity disorder (ADHD).

Some state legislatures have given specific legal protections to drug databases, while others have not. In one case, Oregon required a probable cause warrant for law enforcement access, but the federal Drug Enforcement Administration tried to get the data without one. An ACLU lawsuit resulted in a ruling in which, for the first time, a judge said that patients have a reasonable expectation of privacy in their drug prescription records held in a secure state database and that police do indeed have to get a probable cause warrant under the Fourth Amendment.

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