TASK FORCE STUDIES ABUSE OF NARCOTICS

Program To Monitor Prescription Drugs May Be Improved

FRANKFORT, Ky. - A task force examining solutions to widespread abuse of
narcotics in Kentucky is focusing on improving how the state monitors
prescription drugs.

Allowing authorities to use the monitoring program's data to initiate
investigations of possible drug abuse is likely to be among the main
recommendations of the Prescription Drug Abuse Task Force, its co-chairmen
said yesterday. Speeding up the reporting of drug sales by pharmacies will
probably be another, they said.

These changes could help more quickly identify potential abusers or problem
areas.

The Kentucky All-Schedule Prescription Electronic Reporting system, known
as KASPER, has collected information on 35million prescriptions filled at
Kentucky pharmacies since 1999. But Dr. Rice Leach, the state commissioner
of public health, told the task force that his agency does not have the
legal authority to analyze and report on trends in the data, which would
help fight the rapidly growing epidemic of prescription-drug abuse.

"If it were SARS or smallpox or meningitis, all hell would be breaking
loose," he said. "If we could write rules that would allow my department to
tell you what we know, it would help us intercept it."

Leach said his agency would like to analyze the KASPER data - not to go
after individuals, but to identify risk factors for abuse and look at
prescribing patterns by county or physician specialty.

That idea was popular with the task force's co-chairmen, state Sen. Richard
Roeding, R-Lakeside Park, and Rep. Greg Stumbo, D-Prestonsburg. They said
legislation to allow KASPER data to be used in this way would likely be one
of the top recommendations in the group's final report, which is due Oct 1.

"It will allow us to track and find where the problems are," Roeding said
in an interview after the six-hour meeting, the task force's third and
final session for hearing testimony.

"I think that's the key to solving this thing," said Stumbo, a candidate
for attorney general. He said the KASPER data could be used to identify
problem areas "before it gets to epidemic proportions." He said the
information also could identify physicians prescribing dramatically more
narcotics than the norm for colleagues in the same specialty, so that they
could be referred to the Kentucky Board of Medical Licensure for investigation.

The KASPER system collects information on every controlled substance sold
in Kentucky's 2,100 pharmacies and makes the prescription records of
individual patients available to law enforcement, doctors and pharmacists.
It already is considered a national model for helping to fight abuse of
painkillers and other controlled substances, and this year the legislature
appropriated $1.47million for enhancements.

Those improvements, which will take effect next year, include automating
report requests and making reports available through the Internet to
authorized users, which should cut the turnaround time from four hours to
15 minutes. Reports also would be available 24 hours a day, seven days a week.

Leach said the Cabinet for Health Services has a number of recommendations
for KASPER improvements:

Require pharmacies to report transactions to KASPER at least weekly,
instead of the current twice a month, which would reduce the lag in getting
information into KASPER to three to nine days, down from the current 17 to
31 days.

Require pharmacies to report drug sales electronically, which most already do.

Require pharmacies to report whether an individual paid for a prescription
with cash; the date a prescription was written, not just filled; and
whether it is a new or refilled prescription.

Expand access to KASPER data by out-of-state law-enforcement agencies and
pharmacies and seek reciprocity agreements with other states.

Many of these steps have strong support from the task force, according to a
preliminary ranking of recommendations by panel members. Asked by the task
force staff to rank the recommendations made by witnesses during its first
two meetings, panel members rated various improvements in KASPER as the top
eight recommendations. Speeding up data entry from pharmacists had the most
support.

Yesterday the task force also heard from drug-treatment experts and
providers, who decried the lack of adequate treatment programs in Kentucky,
especially ones more extensive than weeklong detoxification programs, which
they said do not solve the addiction problem.

"You get that patient back through the emergency room over and over and
over," said Charles Housley, executive director of Appalachian Regional
Healthcare.