New system makes it a pain to get Rx drugs illegally

COLUMBUS, Ohio – Pharmacist Jarrett Bauder sometimes becomes suspicious about a customer having a prescription filled for painkillers, especially if it’s someone he doesn’t know.

With so much concern about prescription drug abuse and so-called doctor shopping, he tries to stay alert for potential trouble.

“It’s not something that involves all patients, but you do wonder,” said Bauder, who works at Uptown Pharmacy in Westerville, a Columbus suburb.

Beginning yesterday, Ohio is making it easier for pharmacists, doctors and law enforcement to monitor prescription drug sales and spot abuse. The State Board of Pharmacy will launch the Ohio Automated Rx Reporting System, a computer database that will track sales of all controlled substances and two noncontrolled ones.

About 2,300 retail and mail-order pharmacies that sell to Ohio patients will be required to electronically report prescription sales twice a month to create the database, which has the ability to store 30 million to 35 million prescriptions.

Doctors and pharmacists then will be able to get a report via the Internet to see if patients are visiting multiple physicians and pharmacies to obtain the same types of drugs – commonly called doctor shopping. And law enforcement will be more easily able to uncover criminal activity.

“When you get that suspicious feeling, it’s going to be a nice tool,” Bauder said.

The database will not be accessible by the general public. And patients should notice no difference when visiting their doctors or having prescriptions filled – unless they are up to no good.

“A doctor can look at the report and see that you’ve been going to one doctor and one pharmacy and you’re a legitimate patient,” said William Winsley, executive director of pharmacy board. “But if he sees you going to 15 different doctors and 15 different pharmacies and you’ve been going the next day and then the next day and the next day, they see you might not be a legitimate patient and might not want to write a prescription for you.”

An estimated 48 million people have used prescription drugs for nonmedical reasons at some point in their lifetime, according to the National Institute on Drug Abuse.

Thirteen doctors were disciplined last year by the State Medical Board of Ohio for prescription-related problems.

Ohio will join at least 24 other states with monitoring programs, and 10 other states have enacted laws to create programs, according to the National Alliance for Model State Drug Laws in Alexandria, Va. Every state bordering Ohio has one.

Ohio has seen an influx of people, particularly from Kentucky, trying to avoid detection in their home states by crossing into Ohio to buy prescription drugs, Winsley said.

“We’ve got a case now of patients driving 250 miles one way to northeast Ohio to get prescriptions from a doctor,” he said.

Dr. Robert Taylor, medical director of the pain and palliative care program at the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at The Ohio State University, said the program has potential to thwart abuse and he will likely use it.

But he also cautioned that authorities shouldn’t jump to conclusions. Some patients have been driven to deception because they aren’t receiving adequate care for their pain and aren’t addicts, he said.

Some pharmacists feel the reporting requirement is another government mandate in an already intensely regulated industry, said Ernest Boyd, executive director of the Ohio Pharmacists Association. Some pharmacies have had to pay several hundred dollars to upgrade their software to comply with the program, he said.

The Ohio program, which is expected to cost $400,000 annually, was modeled after Kentucky’s, which has been operating since 1999. The Kentucky All Schedule Prescription Electronic Reporting [KASPER] program responded to 186,279 requests for reports last year.

KASPER leaders haven’t been able to determine how many people have been investigated or charged through the program because numerous law enforcement agencies use the system, according to a state report issued earlier this year. However, the Drug Enforcement and Professional Practices Branch prosecuted 51 doctors, pharmacists and nurses and a physician assistant in 2004, the report said.

Pharmacists in southern Ohio are especially supportive of the program, Boyd said.

“They’ve had a lot of patients streaming over from Kentucky bringing prescriptions, and some aren’t legitimate,” he said. “We hope there is a reduction in drug abuse from this. We think it will help physicians to see if they are being lied to by a patient.”