- The Washington Times - Sunday, August 28, 2005

BALTIMORE — With more states looking for ways to monitor prescription painkillers to prevent drug abuse, Maryland Attorney General J. Joseph Curran Jr. plans to propose a statewide system to keep track of how the drugs are distributed.

The system would use an electronic database to monitor sales of powerful drugs, enabling doctors and pharmacists to know what kinds of drugs have been prescribed for patients. Mr. Curran’s office is preparing a report on the plan, which he expects to make public in about a month.

Mr. Curran emphasized that he doesn’t want to hinder doctors or pharmacists from doing their jobs and he wants to include them in the process of creating the program.

“These drugs that are being abused also have a very good purpose, so we have to be careful that we don’t chill the distribution of drugs to the right people in order to stop it going to the wrong people, so we have to be very careful in how we handle this monitoring,” Mr. Curran said in an interview with the Associated Press.

OxyContin, a powerful painkiller, is an example of a drug that needs closer monitoring, Mr. Curran said. Although legal if prescribed for severe pain, the drug has black-market appeal because snorting or injecting it yields an immediate, heroinlike high.

Monitoring programs aim to cut down on “doctor shopping” by people who visit numerous physicians to acquire multiple prescriptions to feed their addictions. They also are geared toward stopping illegal sales of drugs by physicians or pharmacists.

Mr. Curran plans to ask the General Assembly to approve a way to help fund the Maryland program. His proposal also calls for drawing on federal money set aside to help states support monitoring programs.

President Bush signed into law earlier this month a bill authorizing $60 million to be used to support monitoring programs in all 50 states through fiscal 2010.

A 2002 report by the General Accounting Office, the investigative arm of Congress, found that about 9 million Americans 12 or older reported using prescription drugs such as pain relievers, tranquilizers, stimulants or sedatives for nonmedical purposes in 2000, according to the National Household Survey on Drug Abuse conducted by the Substance Abuse and Mental Health Services Administration.

“If you look at trends over the last 15 years, the abuse of prescription drugs as compared to illicit drugs is increasing more consistently and more dramatically, so you’ve got a problem that’s already higher than I think people think it is and it’s growing faster,” said Carolyn Quattrocki, special assistant to Mr. Curran.

Miss Quattrocki cited a report issued by the federal Substance Abuse and Mental Health Services Administration that indicated the number of admissions for drug treatment from narcotic use rose 240 percent between 1992 and 2002 in Maryland.

There are 21 states with prescription drug monitoring programs, said Sherry Green, executive director of the National Alliance for Model State Drug Laws in Alexandria.

About 10 states are working to set up similar programs. Of those, Colorado, North Carolina, North Dakota and Ohio passed legislation this year to set up monitoring systems, Miss Green said.

Programs in other states are credited with reducing drug abuse and helping crack down on illegal sales. In Kentucky, investigators reduced the average number of days needed to complete a drug investigation from 156 to 16, the GAO report said.

Dave Sallengs, branch manager of Kentucky’s program at the Department for Public Health, Drug Enforcement & Professional Practices, said physicians have been supportive because they have more confidence that prescriptions are being used for medical purposes.

“The doctors are a whole lot more confident that when they’re writing them that they’re writing them for legitimate purposes,” Mr. Sallengs said.

Howard Schiff, executive director of the Maryland Pharmacist Association, said he would like to learn more about how such programs have affected physicians and pharmacists. Mr. Schiff said Maryland pharmacists, who already face other regulatory pressures, likely will be wary.

“It’s going to be met with a feeling that, ‘OK, here we go again. I’m going to have more and more pressure on me,’” Mr. Schiff said.

Some Maryland lawmakers pushed for similar plans several years ago, but met with resistance from medical groups and privacy advocates.

Miss Quattrocki said interested parties, such as pharmacists and patient care and privacy advocates, will be included in discussions to develop the plan.

States have designed monitoring systems in different ways, with some housing the programs with law enforcement and others putting them in a health agency. States also monitor different drugs.

“There are a lot of different variables here as to how you set this up, and so the report is going to sort of identify the many different issues that have to be really carefully looked at,” Miss Quattrocki said.

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