Pubdate: Sun, 07 Jul 2002 Source: Blade, The (OH) Copyright: 2002 The Blade Contact: http://www.toledoblade.com/ Details: http://www.mapinc.org/media/48 Author: Luke Shockman, Blade Staff Writer Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin) DATABASE FOR RX'S COULD GIVE WARNINGS COMPUTER WOULD FLAG PRESCRIPTION MISUSE Joel Levitan caught a drug abuser trying to double up a prescription but admits he was lucky. The Toledo Clinic pharmacist was filling a prescription when his computer alerted him that the person had already gotten the same drug from another pharmacist. It's called "doctor shopping" - a prescription drug abuser visits several physicians in an attempt to get as many prescriptions as possible written for powerful drugs like Valium, Percocet, OxyContin, or other narcotics. Other times abusers resort to stealing prescription pads from doctors' offices or forging prescriptions. In 2000 the federal government estimated 9 million Americans misused prescription drugs, some of which they acquired through "doctor shopping." Mr. Levitan, a past president of the Toledo Academy of Pharmacy, said, "There's a lot" of prescription drug abuse going on locally, just like elsewhere, but that abusers are rarely caught. He said he only discovered the recent abuser because the person used an insurance card and the insurance company's computer database alerted his computer to the duplicate prescription. But there are so many different insurance companies, pharmacists, and doctors that it's difficult to track prescriptions. That gap in Ohio's drug abuse defenses has always been there. But the weakness was highlighted several years ago when Kentucky established a widely praised electronic prescription drug database that tracks all drugs with a potential for abuse. Abusers began going across the border into southern Ohio to doctor-shop. Drug enforcement officials in southern Ohio raised the alarm to state Rep. Tom Raga (R., Mason). He proposed that Ohio establish an electronic drug database like Kentucky's. The bill has passed the House and is awaiting action in the Senate, which is in recess until September. Michigan has a drug database that is paper-based. It has passed legislation to move to an electronic database by next year. Under Mr. Raga's proposal, Ohio's state Board of Pharmacy would administer the database. The estimated start-up cost is $200,000 with annual costs of about $1 million. Funding hasn't been specified but would not come out of licensing fees for pharmacists, according to the Board of Pharmacy. All prescriptions considered "dangerous drugs" - basically all controlled substances with a potential for abuse - that are prescribed in Ohio would be entered into the database. A doctor, pharmacist, or law enforcement agent who was suspicious about a prescription could request a report from the database on an individual to determine if the suspect had filled multiple prescriptions. The system would have automatic alerts that could warn database officials when a high number of prescriptions are being filled by one person. "I think [the system] would be really useful," said Lt. Dan Schultz, head of the Toledo Police Department's vice and narcotics section as well as the Toledo-Metro Drug Task Force. "The abuse of prescription medicine is a big problem, much bigger than most people realize. With this database it sounds like we'd have an [investigative] tool right at our fingertips." Right now he said, criminal investigations of prescription drug abuse often rely on lucky breaks stumbled across by pharmacists like Mr. Levitan. Dr. James North, a Toledo family physician, said he welcomes the proposal. "Pharmacists will call me and say, 'Doctor so-and-so just gave [the patient] that same medication,'" said Dr. North, who is president of the Ohio Academy of Family Physicians. "Personally, I think this would be great." Dr. Lance Talmadge, a Toledo obstetrician and gynecologist, said he runs into three or four cases every year of patients' trying to misuse prescription drugs. "Oftentimes a pharmacist calls us and tells us," said Dr. Talmadge, who is a member of the state medical board. "But if they're smart enough to go to different pharmacies, we never catch them." Dr. Baretta Casey, a family physician in Pikeville, Ky., said she used to run into that situation all the time. But since Kentucky's electronic drug database started in 2000, she has had many fewer problems. "Before, the only way we could get that kind of information was to sit and call every pharmacy and say, 'Has such and such had this prescription filled?'" she said. "Now we fax a request to the state and within 12 hours we get a report back, so we know right away if we've got a problem." Danna Droz, manager of drug enforcement and professional practices for Kentucky's public health department, said state officials have been stunned at how popular the database has become. "We started out thinking we'd maybe get 5,000 requests a year, and we're averaging over 400 requests a day," she said, adding that 78 percent of information requests are coming from physicians. One big weakness in all of the databases, she said, is that none of the state systems is linked to others. Only 15 states have drug databases, according to the federal General Accounting Office, although many states are looking into them. Ms. Droz said ideally there would be a nationwide system because abusers have crossed state lines, which is already occurring along southern Ohio's border with Kentucky. - --- MAP posted-by: Jay Bergstrom