DATABASE FOR RX'S COULD GIVE WARNINGS COMPUTER WOULD FLAG PRESCRIPTION MISUSE

Joel Levitan caught a drug abuser trying to double up a prescription but
admits he was lucky.

The Toledo Clinic pharmacist was filling a prescription when his computer
alerted him that the person had already gotten the same drug from another
pharmacist.

It's called "doctor shopping" - a prescription drug abuser visits several
physicians in an attempt to get as many prescriptions as possible written
for powerful drugs like Valium, Percocet, OxyContin, or other narcotics.
Other times abusers resort to stealing prescription pads from doctors'
offices or forging prescriptions.

In 2000 the federal government estimated 9 million Americans misused
prescription drugs, some of which they acquired through "doctor shopping."

Mr. Levitan, a past president of the Toledo Academy of Pharmacy, said,
"There's a lot" of prescription drug abuse going on locally, just like
elsewhere, but that abusers are rarely caught. He said he only discovered
the recent abuser because the person used an insurance card and the
insurance company's computer database alerted his computer to the duplicate
prescription.

But there are so many different insurance companies, pharmacists, and
doctors that it's difficult to track prescriptions.

That gap in Ohio's drug abuse defenses has always been there. But the
weakness was highlighted several years ago when Kentucky established a
widely praised electronic prescription drug database that tracks all drugs
with a potential for abuse. Abusers began going across the border into
southern Ohio to doctor-shop.

Drug enforcement officials in southern Ohio raised the alarm to state Rep.
Tom Raga (R., Mason). He proposed that Ohio establish an electronic drug
database like Kentucky's. The bill has passed the House and is awaiting
action in the Senate, which is in recess until September.

Michigan has a drug database that is paper-based. It has passed legislation
to move to an electronic database by next year.

Under Mr. Raga's proposal, Ohio's state Board of Pharmacy would administer
the database. The estimated start-up cost is $200,000 with annual costs of
about $1 million. Funding hasn't been specified but would not come out of
licensing fees for pharmacists, according to the Board of Pharmacy.

All prescriptions considered "dangerous drugs" - basically all controlled
substances with a potential for abuse - that are prescribed in Ohio would
be entered into the database.

A doctor, pharmacist, or law enforcement agent who was suspicious about a
prescription could request a report from the database on an individual to
determine if the suspect had filled multiple prescriptions. The system
would have automatic alerts that could warn database officials when a high
number of prescriptions are being filled by one person.

"I think [the system] would be really useful," said Lt. Dan Schultz, head
of the Toledo Police Department's vice and narcotics section as well as the
Toledo-Metro Drug Task Force. "The abuse of prescription medicine is a big
problem, much bigger than most people realize. With this database it sounds
like we'd have an [investigative] tool right at our fingertips."

Right now he said, criminal investigations of prescription drug abuse often
rely on lucky breaks stumbled across by pharmacists like Mr. Levitan.

Dr. James North, a Toledo family physician, said he welcomes the proposal.

"Pharmacists will call me and say, 'Doctor so-and-so just gave [the
patient] that same medication,'" said Dr. North, who is president of the
Ohio Academy of Family Physicians. "Personally, I think this would be great."

Dr. Lance Talmadge, a Toledo obstetrician and gynecologist, said he runs
into three or four cases every year of patients' trying to misuse
prescription drugs.

"Oftentimes a pharmacist calls us and tells us," said Dr. Talmadge, who is
a member of the state medical board. "But if they're smart enough to go to
different pharmacies, we never catch them."

Dr. Baretta Casey, a family physician in Pikeville, Ky., said she used to
run into that situation all the time. But since Kentucky's electronic drug
database started in 2000, she has had many fewer problems.

"Before, the only way we could get that kind of information was to sit and
call every pharmacy and say, 'Has such and such had this prescription
filled?'" she said. "Now we fax a request to the state and within 12 hours
we get a report back, so we know right away if we've got a problem."

Danna Droz, manager of drug enforcement and professional practices for
Kentucky's public health department, said state officials have been stunned
at how popular the database has become.

"We started out thinking we'd maybe get 5,000 requests a year, and we're
averaging over 400 requests a day," she said, adding that 78 percent of
information requests are coming from physicians.

One big weakness in all of the databases, she said, is that none of the
state systems is linked to others. Only 15 states have drug databases,
according to the federal General Accounting Office, although many states
are looking into them.

Ms. Droz said ideally there would be a nationwide system because abusers
have crossed state lines, which is already occurring along southern Ohio's
border with Kentucky.