Pubdate: Mon, 16 Sep 2013
Source: Los Angeles Times (CA)
Copyright: 2013 Los Angeles Times
Contact:  http://www.latimes.com/
Details: http://www.mapinc.org/media/248
Authors: Scott Glover and Lisa Girion

TAKING AIM AT DRUG ABUSE

State Bills Would Provide New Powers to Crack Down on Reckless Prescriptions.

Since her son Joey fatally overdosed in late 2009, April Rovero has 
warned schoolchildren, coeds, cops and congressmen that it was too 
easy for the 21-year-old college student to get the prescription 
drugs that killed him.

In speeches from Sacramento to Washington, she complained bitterly 
that authorities had suspected a Rowland Heights doctor of reckless 
prescribing for years but did little to stop her. Rovero's son was 
one of at least eight men who died on drugs the doctor prescribed.

Rovero's frustration mounted over the years as she saw families lose 
loved ones to a growing prescription drug epidemic. But now, she sees 
reason for hope.

Last week, state lawmakers passed an ambitious slate of reforms aimed 
at giving authorities better tools and broader powers to crack down 
on doctors who recklessly prescribe narcotic painkillers and other 
commonly abused drugs.

The three bills, which garnered strong bipartisan support, await a 
signature from Gov. Jerry Brown that would make them law.

For Rovero, Brown can't act soon enough.

"Each day that passes results in more lives lost to overdose and 
addiction to these drugs," she said.

Brown, who as attorney general railed against prescription drug abuse 
and pill-pushing doctors, declined through a spokesman to say how he 
would respond to the bills.

The proposed legislation was spurred by a series of investigative 
reports in The Times that linked drugs prescribed by doctors to 
nearly half the prescription-involved overdose deaths in Southern 
California from 2006 through 2011.

The Times analysis of coroners' records in four counties identified 
71 doctors who had three or more patients die on drugs they had been 
prescribed.

At the top of the list was Van H. Vu, a Huntington Beach pain doctor 
who has lost 17 patients to overdose, despite what he said were 
state-of-the-art prescribing practices and patient monitoring. The 
Medical Board of California began an investigation into the patient 
deaths after the articles. Vu continues to practice.

The Times also revealed that state Atty. Gen. Kamala Harris was not 
using a state database to identify potentially problematic prescribers.

Following the series, the parents and loved ones of overdose victims 
held a rally in Sacramento calling for reforms that would help expose 
and stop doctors who catered to addicts. Lawmakers threatened to 
abolish the Medical Board of California if it didn't become more 
proactive in dealing with the problem. The Times series prompted two 
proposed laws and created support for another that had twice failed 
in the Legislature.

One bill on Brown's desk is a proposal to require coroners to report 
to the medical board overdose deaths involving prescription drugs. 
The board could then use those reports to link patient deaths to a 
doctor's practice and determine whether reckless prescribing was a factor.

Coauthor Sen. Ted W. Lieu (D-Torrance) said the goal of the bill was 
to give the medical board a tool to detect "patterns of death" as they emerge.

"In too many of these cases, the deadly drugs came straight from a 
bottle with the dead person's own name on it, with a legal 
prescription by a provider," Lieu said.

A second bill would allow regulators to draw a bead on reckless 
prescribing even before overdoses occurred. The proposed legislation 
would bolster the state's prescription drug monitoring program. The 
centerpiece of the program, known as CURES, is a database containing 
detailed information about narcotics dispensed by pharmacies in 
California, including the identities of the prescriber and the patient.

The proactive analysis of such databases is viewed by public health 
experts as key to curbing the toll of prescription drugs. But CURES, 
which is run by the state attorney general's office, was gutted 
during the fiscal crisis, and no one is actively mining it to 
identify problem prescribers.

Sen. Mark DeSaulnier (D-Concord) said his proposed upgrade of CURES 
could revolutionize the way authorities attack the prescription drug 
problem, whether dealing with drugabusing patients or reckless prescribers.

"Before this, it was like looking for a needle in a haystack - just 
searching blindly," DeSaulnier said. With the improvements, he said, 
it would be "more like a surgical strike."

The measure would create a steady funding stream for CURES by 
imposing a $6 annual fee on prescribers and pharmacists.

The third bill is designed to remove roadblocks that medical board 
officials say have hampered their ability to investigate physicians 
suspected of putting patients at risk. Senate President Pro Tem 
Darrell Steinberg (D-Sacramento) said his proposed law would prevent 
doctors from stonewalling investigators by failing to turn over dead 
patients' records or by repeatedly postponing interviews. Doctors who 
fail to cooperate could face board sanctions.

In the end, all three bills enjoyed broad support among lawmakers of 
both parties, as well as consumer and other interest groups. But, as 
introduced, each bill faced stiff opposition from physicians, drug 
makers or both - two of the state's most influential lobbies.

The measures passed after authors accepted amendments that doctors 
and drug makers said would make them fairer. Consumer advocates, 
while applauding passage of the bills, vowed to seek the restoration 
of what they said were key provisions cut during the legislative process.

Bob Pack, whose two young children were killed by an intoxicated 
driver who was being prescribed pain pills by multiple doctors, said 
DeSaulnier's bill on CURES would enable doctors to ferret out 
drug-abusing patients such as the woman at the wheel of the Mercedes 
who ran over his children. But he said the California Medical Assn. 
lobbied hard to remove a requirement that doctors check CURES before 
prescribing narcotics.

Pack said he was pushing for a ballot measure that would include the 
requirement for doctors to check CURES and incorporate other 
abandoned elements of prescription drug legislation. The proposed 
ballot measure also would lift a 38year-old cap of $250,000 on 
medical malpractice awards.

Lieu said he planned to introduce measures in the next legislative 
session in January that would address how physicians prescribe the 
dangerous narcotics implicated in a majority of overdose deaths. He 
said he was particularly interested in some of the prescribing 
guidelines adopted by Washington state three years ago.

The bills now awaiting action by Brown "address the problem at the 
back end," Lieu said. "There are steps that some other states have 
taken that may be useful to California that deal with the front end 
to keep the addiction from happening in the first place."
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MAP posted-by: Jay Bergstrom