Montana News

Nov 19, 2013 12:32 PM by Sanjay Talwani (sanjay@kxlh.com)

Improvements suggested for Montana Prescription Drug Registry

HELENA - Prescription drug abuse is a problem that's getting worse across the nation. Last week, a legislative panel heard from doctors, pharmacists, and law enforcement officials about ways to improve one of the tools in the war against the abuse of painkillers, the Montana Prescription Drug Registry.

Kaye Norris, program director of the Montana Pain Initiative, told the Children, Families, Health & Human Services Interim Committee that according to the U.S. Centers for Disease Control & Prevention, an estimated 6 million Americans are abusing painkillers - more than heroin, cocaine, and hallucinogens combined. That's an increase of 80% over six years, she said.

"It's not exaggerated," said Dr. Bill Gallea, an emergency medicine physician at St. Peter's Hospital in Helena. "It's real, it's serious."

Since going online in March 2012, the prescription drug registry has received data from 763 pharmacies, logging more than 3.8 million prescriptions for more than half a million Montana patients.

Registry staff has responded to more than 150 law enforcement subpoenas.

Gallea said one improvement would be real-time pharmacy data; now pharmacies have up to a couple weeks to put in their data. That means drug abusers who "doctor-shop" could get multiple prescriptions before the data catches up.

Another suggestion: Let people in a practice other than just doctors access the registry.

"It has to be done personally by ourselves, and in a busy emergency environment or in a busy practice right now that's a barrier that we need to address," Gallea said.

He recommended allowing another person in a practice or facility, with understanding of patient-privacy laws, to access the registry.

Gallea also said the registry needs a way to share its data with other states, so patients in Sidney, for example, can't go doctor-shopping in Williston, North Dakota.

Montana's Board of Crime Control recently received a federal grant to work toward sharing the registry with other states. The Legislature will have a chance to consider the recommendations when they meet in 2015.

The issue is made more difficult because doctors want to effectively treat legitimate pain without delivering drugs into the community.

For example, while some of the lawmakers called for a requirement that patients present identification when picking up prescriptions, that could prevent homebound people from getting the medications they legitimately need.

Norris said the nation faces two competing public health crises: untreated chronic pain, and prescription drug abuse. She said a study estimates that 40,000 people in Montana experience severe pain. The World Health Organization has pegged untreated pain as the top health problem in America. Norris said in Montana people with severe chronic pain lose an average of 168 days of productivity per year.

And those with chronic pain are more likely to be uninsured than the general population, she said.

While prescription drug fraud, large-scale trafficking, and doctor-shopping are problems, more than half of all abusers get their drugs for free from family and friends.

Law enforcement officers also testified about the prevalence of the problem.

Alisha Tuss of the U.S. Drug Enforcement Administration in Billings said staff in medical offices from nurses to receptionists steal drugs for transfer to others.

She said, for example, that one doctor in a small practice was known for prescribing the powerful drugs methadone and dilaudid for abuse, and gained a following of patients from around the state and beyond.

Mark Long, chief of the Montana Narcotics Investigation Bureau in the Department of Justice, said his agency focuses on street-level dealers.

He said some people inflict pain on themselves to gain the pain-killers.

And with computer scanners and photo-altering software, he said, abusers can change more easily forge signatures of doctors and change data like drug quantities, types and refill dates.

"We are seeing quite an increase in prescription forgeries," he said.

He said he's heard of some people who actually lock up their medicine cabinets to keep drugs safe,

But, he said, "I've never met one of those."

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