Pubdate: Wed, 25 Jan 2006
Source: Boston Globe (MA)
Contact:  2006 Globe Newspaper Company
Website: http://www.boston.com/globe/
Details: http://www.mapinc.org/media/52
Author: Scott Allen,  Globe Staff
Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone)

STATE SEEKS MORE DATA ON PRESCRIBED PAIN RELIEF

Alarmed by evidence that more than 3 percent of prescriptions for 
addictive pain relievers go to drug abusers, Massachusetts regulators 
announced plans yesterday to identify suspected abusers of OxyContin 
and other narcotics by expanding and analyzing a database of 
prescriptions. Under the plan, the Department of Public Health would 
notify doctors and pharmacists about patients who receive a 
"questionable" number of prescriptions from multiple sources in hope 
they can help those who are addicted to drugs. State officials said 
they would target an estimated 2,500 people who appear to be "doctor 
shopping," visiting numerous physicians and drug stores in a single 
month to amass far more of the drugs than the 30-day supply permitted 
by law. The department would track the pain reliever prescriptions 
for the roughly  500,000 Bay State residents who receive them 
annually. However, the department would pass along information only 
to medical or law enforcement officials.

These officials, under the plan, would receive the names of people 
who receive far more narcotics than could be used  legally by one 
person. "The regulations proposed today will go a long way toward 
achieving a number of important goals on prescription drug abuse," 
said Public Health Commissioner  Paul J. Cote Jr.

State officials declined to say how many prescriptions would be 
considered questionable, but they offered the example of a patient 
who had filled 13 narcotic pain-relief prescriptions at 12 pharmacies 
in four months. But members of the Public Health Council, the 
advisory group that must approve new health regulations, said they 
were concerned that the expanded Prescription Monitoring Program 
could violate patients' privacy or wrongly stigmatize people such as 
cancer patients as drug abusers. "Who makes the judgment of whether 
to push the button" and notify doctors and pharmacists that a 
customer may be illegally obtaining drugs, asked a council member, 
Albert Sherman.

However, the Massachusetts Medical Society, which represents most of 
the state's doctors, endorsed the proposal as long as the tracking 
does not prevent patients from getting care they need and as long as 
doctors are not expected to  play a law-enforcement role.

Under the state plan, customers who appear to be filling drug 
prescriptions for resale, rather than for their own consumption, 
would be  referred directly to law enforcement officials for investigation.

"We're in favor of this," said Dr. Alan Harvey, president of the 
society. Harvey said that doctors have no way of knowing whether 
patients are secretly getting pain relievers from other physicians. 
"We don't want patients to abuse  drugs; it's not good for their 
health," he said. Ideally, he said, the state  would give physicians 
direct access to a website where they could investigate  narcotic 
prescriptions for their patients themselves. Grant Carrow, who 
oversees the Prescription Monitoring  Program, told council members 
that protections for patient privacy would have to  be addressed and 
that the state would have to develop guidance on how to handle 
patients receiving questionable amounts of drugs before the 
monitoring plan can  take effect, a process expected to take at least 
a year. He said a more  aggressive state drug-monitoring program is 
essential to help fight illegal  prescription drug use. Prescriptions 
for OxyContin and other opioids such as morphine rose by 120 percent 
from 1996 to 2005, according to the existing drug monitoring program, 
which collected reports on 2.6 million prescriptions of addictive 
Schedule 2 drugs last year. In part, the rapid rise reflects more 
aggressive treatment of pain, but it also reflects a boom in drug abuse.

This boom has fueled pharmacy break-ins and armed robberies by 
addicts looking for OxyContin. Addicts also shop to meet their craving.

Carrow said more than 3 percent of all the opioid prescriptions last 
year went to customers with multiple prescriptions.

Carrow said the new initiative, funded by a $350,000 federal grant, 
would allow the state to make better use of the drug information it 
gathers from about 1,200 pharmacies, which electronically report to 
the state all prescriptions of  Schedule 2 drugs they fill. Using new 
computer software, state officials can map  when and where each 
customer obtains a Schedule 2 drug. To make the system work, 
pharmacists must do a better job of getting identification, Carrow 
said. Pharmacists frequently submit incomplete  information, omitting 
the name of the customer 25 percent of the time. The  proposed 
regulations would require customers to present identification to 
obtain  Schedule 2 drugs. Still, Carmelo Cinqueonce, executive vice 
president of the Massachusetts Pharmacists Association, said his 
group would like to support better monitoring. "Anything that would 
discourage drug abuse, as long as it doesn't put an excessive, undue 
burden on pharmacies, we would be supportive of that," he said. 
Public Health Council members said yesterday that they need to know 
more about how the system will work before they agree with the plan, 
for instance, what doctors should do when told a patient may be 
drug-addicted. "On paper, this looks great.

I'm concerned about the practical application," said Sherman, the 
council member.
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