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Diagnosing pill abuse problem

HAZARD — At the first of four forums to be held after the shooting death of a Perry County doctor, allegedly by a drug-seeking patient, leaders in the medical and legal professions said solving the region's prescription drug abuse problem will require a cultural shift.

"Drug abuse is not an issue that UNITE, the lieutenant governor, state police or anyone else can solve. It's going to take people in the community," said Karen Engle, director of Operation UNITE, a drug abuse task force in Eastern Kentucky.

Leaders said in some counties up to 40 percent of children live in homes without their parents. Surveys indicate people start abusing drugs as young as age 11, Engle said, and drugs become an accepted part of family life.

"Kentucky has a peculiar culture that creates a lot of quietness and inwardness of its people — physicians must understand that," said Dr. Randy G. Litman of the Pikeville College School of Osteopathic Medicine.

He said doctors who are facing patients who need pain relief but are also addicted to drugs need more options than just refusing to write a prescription. He suggested a mechanism such as a 72-hour hold in jail or a psychiatric facility to deal with patients in a controlled setting.

Hazard pharmacy owner Brooks Webb said he is hamstrung by a law that doesn't let him dispense pills even if he feels his staff or other patients are threatened. Kentucky's prescription drug tracking system, KASPER, doesn't help in a crisis and can't predict whether a patient will become violent, he said.

On the day Dr. Dennis was shot at the Leatherwood/Blackey Clinic in Cornettsville, Webb had a phone call from the pharmacist at the clinic saying that there had been a threat. "We barricaded the pharmacy ... I had just a feeling of helplessness," Webb said.

Lt. Gov. Daniel Mongiardo, a Hazard doctor who helped arrange the series of forums, acknowledged that KASPER tracks only prescriptions that are filled, not prescriptions that are requested and denied. Better training is needed so that doctors can be compassionate and savvy.

"Physicians aren't lie detectors," Mongiardo said.

Perhaps medical professionals should be given easier access to patients' court records so they can tell who might get into trouble if given a prescription, said Perry District Judge Leigh Anne Stephens, who presided over early legal proceedings in the case of John Carles Combs of Redfox, who is accused of shooting Sandlin on Dec. 11. The forum allowed the medical and legal professions to meet in a new way, Stephens said.

"This really pulls everybody in together," Stephens said.

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