STATE DATABASE TO KEEP TABS ON PRESCRIPTIONS

A database to allow the state to keep track of all controlled substance
prescriptions filled in Tennessee goes into effect Wednesday.

Doctors and pharmacists have known for some time that people abuse
prescriptions, either to feed their own drug habit or to get drugs to sell
on the street. However, there never has been any way to keep track of it.

But on Wednesday the Controlled Substances Monitoring Act kicks in, and
that could change.

The act sets up a database to compile every prescription for a specific
list of drugs, many of them painkillers, filled in the state by
pharmacists, doctors and even veterinarians.

It establishes a committee to check the data for trends - to identify one
person filling numerous prescriptions for the same or similar drugs, for
instance - and empowers it to relay that information to the proper medical
authorities and, if necessary, to the proper law enforcement agency.

"The information will, hopefully, be used to detect any patterns of abuse,"
said Baeteena Black, executive director of the Tennessee Pharmacists
Association, which worked to get the law passed. "It will assist in
notifying prescribers and dispensers of drugs of particular patients with
problems. We hope ultimately to be able to identify patients early on and
prevent them from getting into an abusing situation."

State Rep. David Shepard, D-Dickson, a pharmacist who sponsored the bill in
the House, said the idea of tracking prescriptions arose because Tennessee
has an abnormally high use of hydrocodone, a synthetic narcotic marketed
under the brand names Vicodin and Loritab, among others.

"We know there are people filling these for resale or to feed an addiction.
We'd like to find out who they are," he said. "States that have implemented
similar laws have seen a 45% reduction in drug diversion (resale)."

No one is sure how big a problem the abuse of legally prescribed drugs is
in Tennessee, partly because there is so little data.

"We think it's a substantial problem or we wouldn't have gone to all this
effort," said Black, who said the bill was in the works for four years in
the legislature before being approved last summer.

She said many abusers of prescription drugs "begin legitimately, build up a
tolerance, and before long they go to physical and psychological addiction."

The program is being funded through fees paid by pharmacists and other drug
dispensers, she said.

Because the database will contain sensitive information, deciding who has
access to it was a critical aspect of the legislative debate.

"We're writing the rules now for who has access, how the information can be
disseminated, what data are accumulated," said Kendall Lynch, director of
the state Board of Pharmacy.

The board is the keeper of the database. Lynch and two board members are on
the 14-member committee that oversees it.

The biggest debate in the legislature was over how much access law
enforcement officials should have to the data. A compromise was reached,
but proponents of the law insist that was a side issue.

"This is health-care legislation," Lynch said. "You can treat people for
addiction for $3,000 a year, but if you throw them in jail, it'll cost you
$30,000 a year."

Lynch traced the origins of the monitoring act to about four years ago,
when a federal report suggested Tennessee had a high per-capita usage of
controlled substances, particularly hydrocodone.

"The Board of Medical Examiners formed a committee to look into that, and
invited us, law enforcement and some others to participate," Lynch said.
"What became clear to us was, there wasn't any reliable data for us to make
any decisions about anything."

The act requires a report on the dispensing of a controlled substance
unless it is administered directly, such as in an emergency room, is
dispensed in less than a 48-hour supply or is dispensed at a methadone clinic.

Wally Kirby of the Tennessee District Attorney General's Conference said
the law contains safeguards to prevent misuse by law enforcement agencies.

"The DA has to prove probable cause to a judge before he can get access,"
Kirby said. "The safeguards are there so you can't go on a witch hunt."