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.
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