Pubdate: Mon, 30 Dec 2002 Source: Tennessean, The (TN) Copyright: 2002 The Tennessean Contact: http://www.tennessean.com/ Details: http://www.mapinc.org/media/447 Author: Tom Sharp, Associated Press STATE DATABASE TO KEEP TABS ON PRESCRIPTIONS A database to allow the state to keep track of all controlled substance prescriptions filled in Tennessee goes into effect Wednesday. Doctors and pharmacists have known for some time that people abuse prescriptions, either to feed their own drug habit or to get drugs to sell on the street. However, there never has been any way to keep track of it. But on Wednesday the Controlled Substances Monitoring Act kicks in, and that could change. The act sets up a database to compile every prescription for a specific list of drugs, many of them painkillers, filled in the state by pharmacists, doctors and even veterinarians. It establishes a committee to check the data for trends - to identify one person filling numerous prescriptions for the same or similar drugs, for instance - and empowers it to relay that information to the proper medical authorities and, if necessary, to the proper law enforcement agency. "The information will, hopefully, be used to detect any patterns of abuse," said Baeteena Black, executive director of the Tennessee Pharmacists Association, which worked to get the law passed. "It will assist in notifying prescribers and dispensers of drugs of particular patients with problems. We hope ultimately to be able to identify patients early on and prevent them from getting into an abusing situation." State Rep. David Shepard, D-Dickson, a pharmacist who sponsored the bill in the House, said the idea of tracking prescriptions arose because Tennessee has an abnormally high use of hydrocodone, a synthetic narcotic marketed under the brand names Vicodin and Loritab, among others. "We know there are people filling these for resale or to feed an addiction. We'd like to find out who they are," he said. "States that have implemented similar laws have seen a 45% reduction in drug diversion (resale)." No one is sure how big a problem the abuse of legally prescribed drugs is in Tennessee, partly because there is so little data. "We think it's a substantial problem or we wouldn't have gone to all this effort," said Black, who said the bill was in the works for four years in the legislature before being approved last summer. She said many abusers of prescription drugs "begin legitimately, build up a tolerance, and before long they go to physical and psychological addiction." The program is being funded through fees paid by pharmacists and other drug dispensers, she said. Because the database will contain sensitive information, deciding who has access to it was a critical aspect of the legislative debate. "We're writing the rules now for who has access, how the information can be disseminated, what data are accumulated," said Kendall Lynch, director of the state Board of Pharmacy. The board is the keeper of the database. Lynch and two board members are on the 14-member committee that oversees it. The biggest debate in the legislature was over how much access law enforcement officials should have to the data. A compromise was reached, but proponents of the law insist that was a side issue. "This is health-care legislation," Lynch said. "You can treat people for addiction for $3,000 a year, but if you throw them in jail, it'll cost you $30,000 a year." Lynch traced the origins of the monitoring act to about four years ago, when a federal report suggested Tennessee had a high per-capita usage of controlled substances, particularly hydrocodone. "The Board of Medical Examiners formed a committee to look into that, and invited us, law enforcement and some others to participate," Lynch said. "What became clear to us was, there wasn't any reliable data for us to make any decisions about anything." The act requires a report on the dispensing of a controlled substance unless it is administered directly, such as in an emergency room, is dispensed in less than a 48-hour supply or is dispensed at a methadone clinic. Wally Kirby of the Tennessee District Attorney General's Conference said the law contains safeguards to prevent misuse by law enforcement agencies. "The DA has to prove probable cause to a judge before he can get access," Kirby said. "The safeguards are there so you can't go on a witch hunt." - --- MAP posted-by: Beth