DRUG DATABASE WOULD CURB ILLICIT SALES, SOME SAY

TAMPA - In a span of 14 months, Clearwater family physician Jeffery
Prosser prescribed more than 3,500 addictive pain pills to a local
woman, according to a state complaint. She then made the mistake of
selling some of the pills to the teenage son of a pharmacist, who
reported the case.

In Florida, which lacks a database for controlled-drug prescribing, it
typically takes this kind of coincidence - or a string of overdose
deaths - to shut off a source of prescription drug diversion.

Larry Golbom, the Pinellas County pharmacist who reported Prosser to
state health authorities, supports creation of a registry.

"I've been a registered pharmacist for over 25 years, and I am
embarrassed that it took a personal family situation to awaken me to
the problem we have in Florida," he said.

In hopes of creating an electronic database for controlled drugs,
health and law enforcement officials will hold a news conference
Monday in Tallahassee to call for passage of Senate Bill 178. It would
set up a "prescription validation" program for federally controlled
drugs that are frequently abused, such as OxyContin and Vicodin.

With a patient's permission, doctors and pharmacists could check the
database before writing or filling a prescription for a drug that
brings a high price on the street. They could make sure the patient
has not been filling multiple prescriptions for addictive drugs from
different doctors. If the patient refuses, the physician can refuse to
write the prescription.

Without the database, Florida addicts and pushers can "doctor-shop" to
find a physician who will write prescriptions for the drugs they want,
said Bill Janes, director of Florida's Office of Drug Control.

"These drugs are killing people," Janes said, noting that six people a
day die in Florida from such prescription abuse - more than cocaine,
heroin and crystal meth combined. Pill-popping has become a growing
problem among school-age children, he said.

Most cases of overprescribing are handled through the state health
department, and it can take years from the time a complaint is filed
until it is resolved - especially if the physician contests the charges.

Prosser's case, which took more than two years to close, was speedier
than most because he negotiated an agreement to avoid a formal
evidentiary hearing. The terms of the settlement - a $12,500 fine plus
costs, some courses and community service - were mild enough to avoid
triggering a report to the National Practitioners' Data Bank, a
federally sanctioned repository of malpractice claims and disciplinary
actions by health professionals.

In the settlement Prosser signed is a statement that he neither admits
nor denies the allegations. Prosser declined to talk to The Tampa
Tribune on advice from his attorney.

The woman who obtained the prescriptions from Prosser was not
identified in the state complaint. Prosecuting 'Pill Mills'

In recent years, some doctors have been prosecuted in criminal courts
for running so-called "pill mills."

In February, Pasco County sheriff's deputies arrested Satyanarayana
Rao Korabathina and charged him with eight counts of prescription
fraud and two counts of Medicaid fraud. He is out on bail, awaiting
trial. He can continue to practice in the meantime but cannot
prescribe controlled drugs.

Korabathina has denied wrongdoing, telling state officials that he
correctly prescribes medication and always examines patients before
writing prescriptions. He told officials many of his patients were on
controlled substances prescribed by other physicians and he just
continued the same course of treatment

A criminal case that spurred two legislators to sponsor the drug-
registry bill took place in Port St. Lucie. Asuncion Luyao was
convicted last month of trafficking in oxycodone, racketeering and
manslaughter in the death of a patient. She had been charged in
connection with six overdose deaths.

The first painkiller-prosecution case to draw nationwide attention
happened with the arrest of Panhandle pain-management physician James
Graves. He was sentenced to more than 60 years in prison in 2002 for
manslaughter in the overdose deaths of four patients.

The Graves prosecution and those of other doctors who overprescribed
painkillers, particularly OxyContin, led to concerns among two groups:
Some physicians complained that they were afraid of being prosecuted
if they prescribed drugs for which patients had a legitimate need.
Also, patients' advocates said some were enduring unrelenting pain
because of the crackdown on doctors who prescribed the drugs that
could help them. Registry Efforts Stall

The backlash seemed to be gaining traction when a 2005 study reported
a rapid escalation in prescriptions for painkillers, tranquilizers,
sedatives and other drugs susceptible to addiction and abuse. White
House drug czar John Walters and President Bush called for the states
to create electronic databases for controlled drugs. They offered to
subsidize the funding. The National Council of State Legislatures says
28 have signed on so far.

Whether Florida will join them is unclear. The past two years, the
registry bill has passed in the Senate but stalled in the House.

History appears to be repeating itself.

Rep. Joe Negron, R-Stuart, said he is strongly opposed to the bill
because "I don't think it's any of the government's business if you're
getting medical care." He said that as a conservative Republican, he
wants "less government, less regulation and more personal freedom.
This goes against all three of them."

Sponsors of the registry, Sen. Burt Saunders of Naples and Rep. Gayle
Harrell of Port St. Lucie, point out that they also are Republicans.
Gov. Jeb Bush and President Bush, both conservatives, support the drug
database as a tool for law enforcement and public health. Emotion
Clouds Debate

Bill backers have accepted modifications that address Negron's
concerns, such as having the registry operated by a state-paid private
vendor. This model, used by Florida Medicaid and operated by a Tampa
company, Gold Standard Inc., has received positive reviews, even from
Negron.

Medicaid, though, is different, Negron said. If the government pays
for the drugs, as it does for Medicaid patients, it has the right to
monitor their use, he said.

Emotion has crowded out the facts in the debate, Harrell said.
Investigators already can look through prescriptions at pharmacies,
she said, but can't do it efficiently.

Also, private companies such as Humana or United have access to the
prescribing information of their covered patients, with fewer privacy
protections than in the database bill, she said.

Janes, Florida's drug czar, said he is "flabbergasted" at continued
resistance to the controlled-drug database.

"If this is not the right way to deal with it, I'd like somebody to
tell me what is."