Power Of Pain Prescription Database Stops At Borders

States are banding together to try to combat prescription drug abuse. Doctors in many states check a database before prescribing medication. But there's no way for doctors who live on the border to check neighboring states. Now there's a move to change that.

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In Kentucky, more people die from abusing prescription drugs than from car accidents. State health experts and government leaders are doing what they can to reduce drug abuse deaths.

But as reporter Brenna Angel of member station WUKY reports Kentucky needs to reach beyond its borders if it's really going to make a difference.

BRENNA ANGEL, BYLINE: At the Pain Treatment Center of the Bluegrass in Lexington, Dr. Peter Wright sees a lot of patients.

DR. PETER WRIGHT: Can you bend backwards for me? Does that bother you, Bud?

UNIDENTIFIED MAN: Yeah.

ANGEL: Many have been injured in car wrecks or work-related accidents. This patient, a former coal miner, is getting an epidural.

WRIGHT: We are there. I'm going to put the medicine in. OK?

ANGEL: Wright uses what he calls a comprehensive approach to pain management, which includes prescription drugs. But before he writes a prescription, he does a little investigation. He logs into a state database to check how often patients have been prescribed opiates and whether they are seeing multiple physicians.

WRIGHT: We use it, essentially, daily, either myself or one of my designates.

ANGEL: The database is called KASPER, the Kentucky All Schedule Prescription Electronic Reporting system. Every state, except Missouri, has set up its own system. It allows doctors, pharmacists and law enforcement to see if people are doctor shopping, but Wright says there's a problem. These monitoring programs only keep track of data within that particular state, and Kentucky borders seven states.

WRIGHT: In many cases, it's somewhat frustrating because you may have the Kentucky results immediately, the Ohio system later, and you come to find out that the patient also has family in West Virginia.

ANGEL: Many people see multiple doctors for valid reasons, but others do it to feed an addiction or to sell the drugs. More than 11 million prescriptions were filled in Kentucky last year, and about 8 percent of those were written by an out-of-state doctor as far as Florida and California. In 2005, Congress passed legislation to establish a network of state prescription monitoring programs. Charlie Cichon is with the National Association of Drug Diversion Investigators.

CHARLIE CICHON: That was really mirrored after the Kentucky KASPER program that was looking at connecting the states, but because of funding, that program never took off.

ANGEL: Cichon says what hasn't worked at the federal level is now gaining momentum in the private sector. Over the past year, 10 states have started to share data through a program called the PMP InterConnect.

DR. CARMEN CATIZONE: The system works quite easily.

ANGEL: That's Carmen Catizone of the National Association of Boards of Pharmacy, which operates the InterConnect.

CATIZONE: To date, we've processed over 500,000 requests from the states, and the processing time is averaging about five seconds per request.

ANGEL: Pharmaceutical companies fund the InterConnect, and there's no charge to states for the first five years. After that, Catizone says the NABP will have a fee structure in place. The InterConnect has the support of congressman Hal Rogers, a Kentucky Republican. A grant program to help states set up prescription monitoring systems bears his name. He's recently introduced legislation that would help organizations establish guidelines for interstate networks, but Rogers says that's as far as the federal government should go.

REPRESENTATIVE HAL ROGERS: I don't like the idea of a huge federal bureaucracy and a database. I think it would be cumbersome. States ought to be allowed to operate a system that fits their needs and their desires.

ANGEL: The InterConnect expects to have 20 states exchanging prescription data within the coming months, and other organizations are working on setting up their own networks. For NPR News, I'm Brenna Angel in Lexington, Kentucky.

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