WASHINGTON — Kentucky lawmakers are at the center of a political feud over the best way to derail interstate prescription pill trafficking, including the pipeline from Florida that plays a key role in an epidemic of drug abuse in Kentucky.
Republican U.S. Rep. Harold Rogers, whose Eastern Kentucky district is plagued by what one prosecutor called a "tsunami" of pills from out of state, favors one approach to track the flow of drugs. Reps. Ben Chandler and Ed Whitfield support an alternate plan, which competes with Rogers' for limited federal dollars.
From his seat on the powerful House Budget Committee, Rogers has had more success getting money for the program he favors, which is named after him.
Under that program, states get grants through the U.S. Department of Justice to set up or improve ways to monitor prescriptions for controlled substances, such as pain pills and anti-anxiety medication.
The program has funneled $48 million to 47 states and territories since 2002 for prescription-drug monitoring.
Whitfield, a Republican from Western Kentucky, and Chandler, a Democrat who represents Central Kentucky, support a program called National All Schedule Prescription Electronic Reporting, or NASPER. That program would set up uniform guidelines across the country for tracking prescriptions and require states to share information.
The program is managed by the Department of Health and Human Services. It has gotten less than one-quarter of the $48 million it needs through federal appropriations.
Chandler said he requested $10 million for the NASPER program in the 2010 federal fiscal year but didn't get it.
"It has been blocked because the committee is funding a competing program, the Hal Rogers Prescription Drug Monitoring Program," Chandler said. "We think the NASPER program, because it provides a uniform national system, is the way to go. Congressman Rogers feels otherwise."
Interstate pill trafficking is a serious concern in Kentucky. Late last month, police from several agencies started the largest drug raid in state history, targeting hundreds of people accused of selling drugs obtained through legal prescriptions from Florida.
One state police supervisor said the agency has information on 1,700 people traveling to Florida to get prescriptions, called doctor shopping.
One key reason people leave Kentucky to get drugs is the state's successful prescription-monitoring system, called KASPER, the model for the NASPER idea. Doctors and pharmacists use it to check whether a person is visiting multiple doctors to get drugs, and police use it to investigate drug dealing.
People seeking drugs for the black market leave Kentucky to escape that scrutiny. Many go to South Florida because it has a lot of pain clinics and there is no prescription monitoring system in the Sunshine State.
The Florida legislature has required that such a system be set up by Dec. 1, 2010. However, the state won't put it in place without federal grants or private funding, said Eulinda Smith, spokeswoman for the Florida Department of Health.
Smith said Florida will apply for grants for the system through the Hal Rogers program. The proposed system isn't equipped to share data nationally, so the state can't seek money through NASPER until its law changes to allow such information sharing, Smith said.
Until Florida has a system to spot people from Kentucky going to multiple doctors for prescriptions and clamps down on clinics distributing pills too easily, police in Kentucky will have a harder time stopping drug dealers and addicts from going south for narcotics, said David Gilbert, executive director of the Lake Cumberland Area Drug Task Force.
"I think it's going to continue until Florida clamps down on its distribution," he said.
Philosophical differences are at work in the tug-of-war over the best approach to setting up prescription-monitoring systems.
Rogers' program offers states a greater degree of autonomy in sharing information and prescription data with other states.
The Justice Department, which sponsors the Rogers grant program, thinks the size and cost of a national data base like NASPER might be prohibitive.
Critics accuse Rogers of blocking NASPER funding to ensure that the program named for him has no competition.
"Here's a perfect example of one legislator worried about his legacy rather than what's best for everyone," said David Kloth, a member of the Association of Interventional Pain Medicine, which pushed for passage of NASPER.
Rogers, however, strongly disputed that charge. A national program such as NASPER would prove too costly and unwieldy, he said.
"NASPER is based out of Washington and is funded through HHS, which could preclude state and federal law enforcement officials from being part of this important process," Rogers said. "Not to mention that a national program would create a huge, expensive bureaucracy that does nothing more than duplicate what we are already successfully doing at the state level."
Several police officials said they applaud Rogers' efforts to address the issue of prescription-drug monitoring but would prefer having a uniform, national tracking system, as long as officers could use it for investigations.
"Conceptually, I think a national approach is the best approach," said Ron Brooks, president of the National Narcotic Officers' Associations' Coalition.
Having a variety of state drug-tracking systems might create gaps or inconsistencies that people seeking to divert pharmaceuticals will try to exploit, several narcotics officers said.
Police said monitoring systems vary from state to state, are not formally linked and might have different rules about what information is collect and who can access the system. Some states have no system.
"That is the chief reason we're in the mess we're in in Florida," said Dave Keller, a retired FBI agent and director of the Kentucky section of the Appalachia High Intensity Drug Trafficking Area, which includes 66 counties in Kentucky, West Virginia and Tennessee.
The National Association of Boards of Pharmacy has not taken a position on whether it supports Rogers' approach or NASPER. However, officials with existing state programs have said a state-based approach is preferable, said Carmen Catizone, executive director of the association.
Even though his idea has taken a back seat to Rogers' approach in funding, Whitfield said he is encouraged by the Obama administration's support for the NASPER program.
"President Obama had NASPER in his budget this time, and we know there's support," said Whitfield, of Hopkinsville. "I'm quite confident that NASPER will be funded and will be increased every year."