Pubdate: Sun, 24 Nov 2002
Source: Courier-Journal, The (KY)
Copyright: 2002 The Courier-Journal
Contact:  http://www.courier-journal.com/
Details: http://www.mapinc.org/media/97
Authors: Bonnie Harris and R. Joseph Gelarden, The Indianapolis Star
Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone)

LACK OF MONEY HINDERS STATE'S TRACKING OF ADDICTIVE PRESCRIPTIONS

INDIANAPOLIS -- Some of the most addictive prescription drugs on the market 
are not monitored in Indiana -- hindering investigations of doctors, 
pharmacies and patients who may be involved in drug crimes.

It comes down to money. And unlike some other states, Indiana has failed to 
come up with enough.

That means drugs such as Vicodin, Xanax and Tylenol 3 -- all classified as 
Schedule III or IV and all highly addictive -- aren't monitored.

Instead, the state tracks only the use of Schedule II drugs such as 
OxyContin through the Indiana Schedule Two Electronic Monitoring Program, 
created in 1995.

''All the bad docs went to Schedule IIIs almost overnight,'' said Mike 
Garrett, a recently retired Indiana State Police detective.

The program helps law enforcement track doctors who overprescribe, 
pharmacies that fill fraudulent prescriptions and patients who abuse drugs.

But having access only to Schedule II prescriptions is frustrating, said 
Gretchen Yordy, a state police investigator.

''If Schedule IIIs and IVs were included, I can call and get information 
from INSTEP,'' Yordy said. ''Now I have to start randomly calling 
pharmacies. I grab the phone book and I start looking at the surrounding 
pharmacies, and I start calling them one by one.''

There are 15 states with programs to monitor prescription drugs. Only five 
monitor more than Schedule II.

In Kentucky, where state health officials run one of the nation's model 
programs, tracking Schedule III and IV drugs has had dramatic effects.

Before starting the program in 1999, Kentucky's drug control investigators 
took an average of 156 days to complete an investigation of alleged 
''doctor shoppers'' -- people who enlist dozens of doctors to write them 
prescriptions.

Investigation time dropped to 16 days last year, according to a report by 
the federal General Accounting Office.

Still, the main purpose is not law enforcement, said Danna Droz, who 
oversees Kentucky's drug-control branch. The program shares information 
with doctors so they can spot abusers.

Fifteen states operate monitoring programs to control illegal distribution 
of prescription drugs. Some states use a multiple-copy prescription 
monitoring program, while others transmit data electronically.

Indiana legislators hoped the system would work as well here. The 1994 law 
that created Indiana's drugmonitoring program allowed the officials to 
track all schedules of prescription drugs.

The intention was to monitor specifically Schedule II-IV drugs, said Sen. 
Robert Meeks, R-LaGrange, who sponsored the Senate bill that shifted 
oversight to the state police in 1999.

The legislature didn't provide funding, but it did give two boards the 
power to decide which drugs to track: the Indiana State Board of Pharmacy 
and the Indiana Controlled Substances Advisory Committee, which advises the 
pharmacy board.

Those bodies decided to track only Schedule II drugs. (Schedule I drugs, 
such as heroin and marijuana, are illegal.)

The pharmacy board wanted to include Schedules III, IV and V, said Donna 
Wall, a pharmacist and the board's former president. But state health 
officials advised them that the state didn't have funds to do it.

''Adding III, IV and V would give you a much fuller picture of controlled 
drugs in the state,'' Wall said.

Money remains the problem.

The state might have qualified for a new federal grant had it expanded the 
program, said Lisa Hayes, executive director of the Indiana Health 
Professions Bureau, the administrative arm of the pharmacy board. One way 
to expand would be to monitor Schedule III and IV drugs.

The program costs the Indiana Health Professions Bureau about $102,000 a 
year, all of it paid to a Massachusetts company, Atlantic Associates, that 
compiles data submitted by pharmacies. The state also has four 
investigators to crack down on pharmacies that don't report monthly as 
required by the law.

Expanding to include Schedules III and IV would raise the cost to about 
$344,000 a year, according to minutes of the Indiana Controlled Substances 
Advisory Committee.

Dr. Stephen Tharp, former president of the Indiana State Medical 
Association, worries that the state won't be able to keep up with 
monitoring if Schedule III and IV drugs are added.

''They have difficulty keeping up with Schedule IIs,'' he said.

Reporting Schedule III and IV drugs wouldn't make more work for 
pharmacists, said Skip Tucker, owner of Tucker Pharmacy & Health Care on 
the Southside.

''The work for us would not change because it gathers the data 
electronically,'' he said.

But while the potential for good monitoring is in place, the dollars 
aren't, said Lynn Willis, chairman of the program's advisory committee and 
a professor of pharmacology at Indiana University-Purdue University 
Indianapolis.

''There really isn't enough money to run this program the way it should be 
done,'' Willis said.

The Health Professions Bureau is considering proposing legislation during 
next year's General Assembly that would take control of the program away 
from the state police and give it back to the bureau, Hayes said.

State police Maj. Robert Holland, a member of the advisory committee, said 
the police are operating the program well.

Another piece of legislation involving the program also could come up next 
year.

Meeks, a retired Indiana state trooper, may sponsor a law that would 
require the monitoring of Schedule III and IV drugs. He still supports the 
program, however, even in its limited form.

''This is a good program,'' Meeks said. ''It gets the bad guys.''

Indianapolis Star staff writer Scott MacGregor contributed to this story.

law, most of Indiana's 1,400 pharmacies must report every prescription they 
dispense for a Schedule II drug. That information goes to a computer 
database overseen by the Indiana State Police. Law enforcement officers may 
access the information as they investigate drug cases.
- ---
MAP posted-by: Jo-D