EARLEY BACKS DATABASE OF ABUSABLE MEDICINES

RICHMOND -- Taking codeine for severe back pain? Get a little Tylenol
3 after your wisdom teeth came out? Or some percodan after your surgery?

Right now, that's between you, your doctor, your pharmacist and your
insurance company.

But Republican gubernatorial candidate Mark L. Earley wants to put one
more entity in the loop: the state. A state government database, to be
exact.

The little-noticed proposal has privacy advocates aghast, the Virginia
State Police hopeful and the medical and pharmacy communities divided.

Earley is pitching the idea in response to the OxyContin problem that
has flared in the southwestern part of the state.

OxyContin is a legal prescription drug that delivers pain-killing
medicine, but people who abuse the drug crush it and inject it for a
potent -- and potentially lethal -- high. More than 100 deaths
nationwide have been linked to its abuse, with nearly half coming from
Virginia.

The Virginia State Police has a 16-person "drug diversion" unit to
combat the illegal use of OxyContin and other prescription drugs. The
unit already has the power to go into any pharmacy without a warrant
and demand records when it's pursuing an investigation.

But when an abuser is filling copies of the same prescription at many
pharmacies, it takes investigators a huge amount of time to get the
information they need, said Rod Bess, assistant special agent in
charge of the drug diversion unit.

What would help, he said, is to have a database of all drugs with
abuse potential that are dispensed in the state.

Eighteen states have already created "prescription monitoring
program" databases, with varying degrees of success. Kentucky's
system is cited as one of the best. Drug diversion investigations
there now take one-tenth the time they used to take. Earley proposes
creating a database that would track doctor, pharmacy and patient
information for all Schedule II and III narcotics dispensed in Virginia.

In addition to OxyContin, which is a Schedule II or
high-abuse-potential legal narcotic, the list includes codeine,
demerol, methadone, which is used for pain relief as well as for
treating heroin addiction, percodan, vicodin, Tylenol 3 and other
mixtures of codeine with over-the-counter pain relievers.

The database would be housed in the Virginia Department of Health
Professions and opened to the state police only when they're on a case.

This kind of information is already sent to insurance companies, Bess
said. And for patients who use Medicaid, the state insurance program
for the very poor, the state already has the data.

"We're just asking that it be directed to one more location," Bess
said. "Once the information goes in, if there's nothing that raises a
flag about it, nobody knows about it but the computer."

"The prescription monitoring program doesn't get law enforcement any
more information -- it gets it to them quicker," Earley spokesman
David B. Botkin said.

"It's like the Department of Motor Vehicles. If law enforcement had
to go to each local DMV like they do to different pharmacies instead
of a centralized DMV electronic record depository in Richmond, it
would be very difficult for law enforcement to prevent crime."

But Harvey B. Morgan, a retired pharmacist and Republican state
delegate from Gloucester, called the proposal "Big Brother at its
worst."

Suffolk Republican Del. S. Chris Jones, a practicing pharmacist,
agreed. "It's a real concern I have, weighing one's right to privacy
with the government's right to know," he said.

A statewide congress of pharmacy schools and organizations hasn't yet
taken a position on Earley's proposal. But Dr. Barry Bleidt, who
teaches at the Hampton University School of Pharmacy and works part
time at a chain drug store, said he has grave concerns.

Proponents of the plan say they could make the database secure and
sharply limit who had access to it, but Bleidt doesn't trust such
promises. "If you can send information into it electronically, guess
what? It can be taken out electronically." He also fears that
proposals like this will make doctors more reluctant to prescribe
potent painkillers at a time when the medical community has begun to
make great strides in pain management. A decade ago, he said, it was
much harder for people with debilitating pain to get powerful medication.

Not everyone in the medical community agrees. Randy Watts, executive
director of the Virginia Association for Hospices, said he is not
concerned as long as law enforcement doesn't inject itself between the
physicians and their patients.

And Dr. Craig Kirkwood, manager of pharmacotherapy services at the
Medical College of Virginia in Richmond, thinks it's a good idea.
"We're all concerned" about prescription drug abuse, he said. Fears
of hacking "in and of itself shouldn't prevent this from happening,
because it's needed." Democratic candidate Mark R. Warner is willing
to consider a more limited program that would track only drugs with
demonstrated abuse problems, like OxyContin.

"He'd want to examine the idea and make sure it's done the right way,
but like most Virginians, he has concerns about privacy issues," said
Warner spokesman Mo Elleithee. "He wants to make sure that someone
who's using something like Tylenol with codeine doesn't end up on a
database." The American Civil Liberties Union is firmly against it.

Libertarian candidate for governor William Redpath also is offended.
"It's things like this that make me a Libertarian instead of being a
Republican," he said. "I think it is a terrible encroachment on our
freedoms to be compiling a database like this."