STATE SEEKS MORE DATA ON PRESCRIBED PAIN RELIEF

Alarmed by evidence that more than 3 percent of prescriptions for
addictive pain relievers go to drug abusers, Massachusetts regulators
announced plans yesterday to identify suspected abusers of OxyContin
and other narcotics by expanding and analyzing a database of
prescriptions. Under the plan, the Department of Public Health would
notify doctors and pharmacists about patients who receive a
"questionable" number of prescriptions from multiple sources in hope
they can help those who are addicted to drugs. State officials said
they would target an estimated 2,500 people who appear to be "doctor
shopping," visiting numerous physicians and drug stores in a single
month to amass far more of the drugs than the 30-day supply permitted
by law. The department would track the pain reliever prescriptions
for the roughly 500,000 Bay State residents who receive them
annually. However, the department would pass along information only
to medical or law enforcement officials.

These officials, under the plan, would receive the names of people
who receive far more narcotics than could be used legally by one
person. "The regulations proposed today will go a long way toward
achieving a number of important goals on prescription drug abuse,"
said Public Health Commissioner Paul J. Cote Jr.

State officials declined to say how many prescriptions would be
considered questionable, but they offered the example of a patient
who had filled 13 narcotic pain-relief prescriptions at 12 pharmacies
in four months. But members of the Public Health Council, the
advisory group that must approve new health regulations, said they
were concerned that the expanded Prescription Monitoring Program
could violate patients' privacy or wrongly stigmatize people such as
cancer patients as drug abusers. "Who makes the judgment of whether
to push the button" and notify doctors and pharmacists that a
customer may be illegally obtaining drugs, asked a council member,
Albert Sherman.

However, the Massachusetts Medical Society, which represents most of
the state's doctors, endorsed the proposal as long as the tracking
does not prevent patients from getting care they need and as long as
doctors are not expected to play a law-enforcement role.

Under the state plan, customers who appear to be filling drug
prescriptions for resale, rather than for their own consumption,
would be referred directly to law enforcement officials for investigation.

"We're in favor of this," said Dr. Alan Harvey, president of the
society. Harvey said that doctors have no way of knowing whether
patients are secretly getting pain relievers from other physicians.
"We don't want patients to abuse drugs; it's not good for their
health," he said. Ideally, he said, the state would give physicians
direct access to a website where they could investigate narcotic
prescriptions for their patients themselves. Grant Carrow, who
oversees the Prescription Monitoring Program, told council members
that protections for patient privacy would have to be addressed and
that the state would have to develop guidance on how to handle
patients receiving questionable amounts of drugs before the
monitoring plan can take effect, a process expected to take at least
a year. He said a more aggressive state drug-monitoring program is
essential to help fight illegal prescription drug use. Prescriptions
for OxyContin and other opioids such as morphine rose by 120 percent
from 1996 to 2005, according to the existing drug monitoring program,
which collected reports on 2.6 million prescriptions of addictive
Schedule 2 drugs last year. In part, the rapid rise reflects more
aggressive treatment of pain, but it also reflects a boom in drug abuse.

This boom has fueled pharmacy break-ins and armed robberies by
addicts looking for OxyContin. Addicts also shop to meet their craving.

Carrow said more than 3 percent of all the opioid prescriptions last
year went to customers with multiple prescriptions.

Carrow said the new initiative, funded by a $350,000 federal grant,
would allow the state to make better use of the drug information it
gathers from about 1,200 pharmacies, which electronically report to
the state all prescriptions of Schedule 2 drugs they fill. Using new
computer software, state officials can map when and where each
customer obtains a Schedule 2 drug. To make the system work,
pharmacists must do a better job of getting identification, Carrow
said. Pharmacists frequently submit incomplete information, omitting
the name of the customer 25 percent of the time. The proposed
regulations would require customers to present identification to
obtain Schedule 2 drugs. Still, Carmelo Cinqueonce, executive vice
president of the Massachusetts Pharmacists Association, said his
group would like to support better monitoring. "Anything that would
discourage drug abuse, as long as it doesn't put an excessive, undue
burden on pharmacies, we would be supportive of that," he said.
Public Health Council members said yesterday that they need to know
more about how the system will work before they agree with the plan,
for instance, what doctors should do when told a patient may be
drug-addicted. "On paper, this looks great.

I'm concerned about the practical application," said Sherman, the
council member.