PRESCRIPTION FOR ABUSE

THE long, sordid story of the massive prescription drug bazaar in South
Shore, Ky., underscores three uncomfortable facts about the trade in
addictive and potentially deadly prescription drugs.

First, the trade relies on prescriptions written by doctors. Second, it
relies on prescriptions filled by pharmacists. Third, the medical
professionals willing to become suppliers instead of healers rely on the
investigative weaknesses and/or disciplinary leniency of the state boards
responsible for policing them.

Curbing the scourge of prescription drug abuse will require tough action on
all three fronts, as well as more tools for honest doctors and druggists to
use in spotting doctorshopping addicts.

The scope and openness of the South Shore operation, as detailed in staff
writer Gideon Gil's series ''Prescription for Abuse,'' were shocking.
Without much pretense of doing anything else, doctors at the Plaza
Healthcare clinic are alleged to have handed out, for the price of an
office visit, prescriptions for addictive painkillers and tranquilizers to
thousands of addicts and suppliers from a four-state region. Customers
lined the roads and turned the parking lot into an open-air drug market.

Certainly, there are encouraging aspects of the story. One is that federal,
state and local law enforcement agencies mounted an aggressive
investigation that resulted in indictments of five doctors.

Another is that Kentucky now has in place one of the nation's most
comprehensive computerized systems for monitoring prescriptions -- a system
that, with further investment, should help not only after-the-fact criminal
investigations like this one but also before-the-fact checking of
suspicious patients by doctors and pharmacists.

But there are also some hard lessons to be learned from the South Shore story.

The fact that two of the five indicted doctors had been allowed to continue
practicing despite earlier disciplinary problems is telling. The state
Medical Licensure Board must resolve to conduct vigorous background checks
of prospective doctors, to be less forgiving of any who fudge past
transgressions and to be more quick to yank the licenses of repeat offenders.

Similarly, the troubling histories of two pharmacists associated with the
South Shore drug store suggest that the state Pharmacy Board needs to put
on more muscle, too.

Finally, the dearth of state monitoring systems like Kentucky's, and the
inability of those that exist to coordinate with each other, show the need
for a national approach to what clearly is a serious interstate problem.