Pain-pill pipeline from Florida to Kentucky drying up, officials say

Attorneys General call for more state, federal action

bestep@herald-leader.comJanuary 20, 2012 

The pain-pill pipeline from Florida that has brought staggering amounts of prescription drugs to Kentucky is beginning to dry up, top prosecutors from the two states said Thursday.

New programs and rules in Florida, along with enforcement in both states, have helped cut the flow of drugs to Kentucky from the Sunshine State, the officials said.

"I certainly get a sense that the Florida pipeline is starting to close off," Kentucky Attorney General Jack Conway said.

However, Conway said more needs to be done to attack the epidemic of prescription drug abuse in Kentucky.

He said he expected state lawmakers to introduce a measure next week aimed at cracking down on illegal use of prescription drugs.

Conway and Florida Attorney General Pam Bondi spoke Thursday at a conference on substance abuse in Lexington, sponsored by several programs at the University of Kentucky and others.

Florida became a key source of pain pills and other prescription drugs for traffickers and addicts in Kentucky and many other states in recent years because it had lax regulation of pain clinics and no system for tracking prescription drugs dispensed there.

Van loads of people routinely went from Kentucky to Florida, paying cash at storefront clinics to get pills after little or no examination.

Authorities found files on 1,400 people, most of them from Eastern Kentucky, when they raided a South Florida doctor in May 2010, according to a court file.

Conway said that in 2010, police estimated 60 percent of the pills sold on the black market in Kentucky were prescribed in Florida.

Florida officials have made a number of moves aimed at cracking down on the problem, included boosting enforcement, requiring pain clinics to register with the state, barring many clinics from dispensing pills, and putting in place a prescription monitoring system.

There have been significant results, Bondi said at the conference.

In 2010, for instance, 98 of the top 100 U.S. prescribers of the pain medication oxycodone were in Florida, but the number now is 11, she said.

One street in Fort Lauderdale once had 27 pain clinics but now has one, Bondi said.

Statewide in Florida, the number of registered pain clinics has dropped from 943 to 579, according to Bondi's office.

"We're shutting the bad guys down left and right," she said.

Conway and Bondi said they have worked closely on the issue.

However, authorities have noticed a resurgence in Kentucky of suspect pain clinics — sometimes called pill mills — perhaps driven by the crackdown in Florida.

That has brought calls for tighter regulation of pain clinics in Kentucky.

For instance, Senate Bill 42, sponsored by Sens. Jimmy Higdon, R-Lebanon, and Robin Webb, D-Grayson, would set up licensing and other requirements for pain clinics.

Conway, Gov. Steve Beshear, House Speaker Greg Stumbo, D-Prestonsburg, and other officials have called for additional measures as well.

Conway said he expects a bill to be introduced next week that will address the problem in a number of ways.

The bill, which still is being drafted, will include a requirement for health care providers who prescribe certain controlled substances to register with the state's prescription-monitoring system, known by the acronym KASPER, Conway said.

The bill also will require emergency rooms to get a KASPER report before dispensing certain pills. The reports allow doctors and other health care providers to see whether a person has received pills from other providers.

Other parts of the legislation would strengthen administrative penalties for doctors who overprescribe drugs, speed up the process of reviewing providers suspected of improperly prescribing, and bar cash-only clinics, Conway said.

Conway said he also thinks it should be mandatory for certain providers to get a KASPER report before writing a prescription.

As it is, fewer than 25 percent of doctors use the system, Conway said.

He also argued that police must have better access to the prescription database. Police now must get information from other sources about suspected overprescribing and open a case before they may request data from the system. Stumbo said earlier this month that he intended to file legislation that would transfer authority over KASPER from the Cabinet for Health and Family Services to Conway's office.

Conway said federal officials also need to push for all 50 states to have prescription-monitoring systems and to share information.

More than 35 states have such systems and others have authorized them, but the system in Georgia, for instance, is not in place. Police in Kentucky say they have seen an upswing in Kentuckians going to Georgia for prescriptions.

Missouri is one of two states that have not approved a monitoring system. That is a concern, Conway said.

He and Bondi also stressed the importance of educating young people and others about the dangers of prescription drugs, and of people locking up their medications at home so others can't get access to them.

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