Daily Independent (Ashland, KY)

October 19, 2012


Law designed to curb pain pill epidemic is working well

The Independent

ASHLAND — While many physicians, other medical providers and patients are complaining that a new law intended to reduce the prescription drug epidemic that has plaqued this region for more than a decade has increased the cost of the medicines they need, Gov. Steve Beshear said the law is having the desired impact by making it more difficult for addicts to get the pain killers they need to feed their habits.

Since the bill took effect in July, 10 pain management clinics have closed and the numbers of prescriptions issued for the most commonly abused drugs have declined.

The governor said supporters knew the new law would have “an immediate impact on thwarting the abuse and diversion of prescription drugs in our state, and the statistics over the last few months are already showing results.”

House Bill 1, sponsored by Democratic House Speaker Greg Stumbo, was enacted during a special legislative session, because legislators could not reach a compromise on the bill during the 60-day regular session, mainly because of opposition from the medical community that was reluctant to recognize the role physicians play in the prescription drug epidemic. The new law requires pain management clinics to be owned by licensed physicians and requires prescribers of the drugs to register with the state’s electronic drug tracking system, KASPER. Prescribers are also required to check KASPER for a patient’s prior drug history and report prescriptions issued to them.

Critics complain that emergency regulations — written by the Beshear administration and the Kentucky Board of Medical Licensure — have exceeded the original intent of legislators. They say legitimate users of the drugs — those with traumatic injuries or chronic conditions, surgery and cancer patients — are often subjected to expensive tests and reporting requirements that either delay, or, in some cases, deny needed treatment.

Despite those complaints, Beshear said Tuesday there will be no let-up in the effort to crack down on drug abusers and those who misuse the system to profit from addiction. Nor should there be. The prescription drug epidemic not only is affecting the lives of those who become addicted to prescription pain pills, but it also is destroying families and is the major cause of crime in this region. Hundreds of individuals have died because of this epidemic and it must be stopped. It is destroying the very lifeblood of many area communities.

“Too many families and communities have been shattered by prescription drug abuse,” Beshear said. “We will not let up on these doctor shoppers and greed-driven practitioners who continue to supply poisons to addicted Kentuckians.”

In 2012 there were 44 pain management facilities in Kentucky, according to the Office of Inspector General. Since then 18 have closed, 10 of them since passage of HB 1.

The number of registered users of KASPER has also dramatically risen, nearly tripling from 7,911 accounts when HB 1 passed to 21,542 on Oct. 1. Before passage of the bill, KASPER averaged about 2,880 reports each day, but according to the Cabinet for Health and Family Services, it is now processing on average about 18,000 a day.

The cabinet claims about 93 percent of those requests are processed in less than 15 seconds, but some physicians consider it a nuisance to check with KASPER before prescribing a highly addictive pain medications.

A recent arrest in Louisville points to just how far some individuals will go to obtain their prescription pain pills and the critical role KASPER can play in preventing them from getting their pills.

Louisville police say Michael A. Osswald, 42, of Louisville obtained painkiller prescriptions from 28 different dentists during a five-month period. According to his arrest warrant, police believe Osswald went to the dentists complaining of pain in order to get prescriptions for Hydrocodone and Tramadol. The warrant says he filled the prescriptions at several pharmacies, often going to the same pharmacies for duplicate orders. He is charged with 22 counts of fraud in connection with the case.

If the dentists had informed KASPER of each prescription they wrote for pain medications and if the pharmacies had checked with KASPER before filling the prescriptions, it would have been impossible for Osswald to get prescriptions filled at so many different drug stores. KASPER  is a great tool for identifying those who abuse prescription drugs — but only if it is used as intended by physicians and pharmacists.

According to the cabinet, there were 219 million dosages of hydrocodone, a powerful painkiller, dispensed in Kentucky in 2011, the equivalent of 51 doses for every person in the commonwealth. But in August of this year after implementation of HB 1, doses fell by 1.6 million. The cabinet also reports significant declines in the dispensing of oxycodone, Xanax and other pain medications.

Maybe the bill has increased the cost of prescription pain medications for legitimate users, but if it helps bring an end to the prescription drug epidemic, that is a small price to pay. If there are problems with the implementation of the law, then fix it, but don’t abandon a law that is working just because some doctors don’t like it.