Piecemeal plan to fight pill abuse

There was more than one kind of hope in the air when Georgia recently became the 35th state to approve a prescription-monitoring program.

In Georgia, people fighting prescription drug abuse and families suffering from it were hopeful the legislation will stem the rising tide of dependency.

In Kentucky, officials were hopeful Georgia's law will make that state a less welcoming stop on the "pill pipeline" that has fueled sales and abuse of prescription drugs here.

The other kind of hope mentioned in Bill Estep's story on Georgia's law underscores the tenuous nature of this state-by-state progress.

"Georgia officials hope to have the monitoring system in place by the start of 2013. However, that is contingent on getting grants to fund it, said Georgia state Sen. Buddy Carter, a pharmacist who sponsored the bill," Estep wrote.

We hope Georgia will get those grants. But we'd be more optimistic if funding weren't based on hope.

A similar law passed in Florida earlier this year is close to becoming a reality, but only after a bitter debate about privacy issues and paying for the program in economic hard times.

Estimates are Florida's system will go online this fall; Georgia, hopefully, will be up and running in 2013. Efforts to link the systems so information can be shared from state to state are in their infancy.

"We're making progress, it's just slow," Dave Hopkins, head of Kentucky's system and an officer in a national alliance of states with monitoring systems, told Estep.

There's every indication the rate of prescription drug abuse is outpacing the monitoring system.

The total number of overdose deaths in Kentucky rose from 403 in 2000 to 978 in 2009. During that period, overdose-related deaths more than doubled among men and tripled among women, according to the state Cabinet for Health and Family Services. Confirmed overdose deaths in Floyd County jumped from 15 in 2009 to 43 in 2010, according Brent Turner, the commonwealth's attorney there. Florida averages seven overdose deaths a day.

Addiction and money are powerful things. Markets can react with deadly efficiency; plug one hole and the action will flow to the next crack in the system.

When Kentucky pioneered its monitoring system, the pill pipeline came to life; as Florida began cracking down, business picked up in Georgia. When and if Georgia gets its system in place, there's every likelihood the traffic will jump to another state.

All this makes it hard to understand why there's still opposition to creating and funding a national monitoring system.

We know it's popular now to howl about big government. But if a national government has any legitimate use, it is certainly to stop something like the pill pipeline that operates across state lines.

There are also legitimate concerns about privacy. But those concerns are just as real for the state programs and any efforts to link them, so it seems almost paranoid to think a federal system would be more intrusive. What a national system would be, hopefully, is more seamless and coordinated.

As long as even a few states don't have monitoring systems the market will move to those areas of opportunity. And, as the examples of Florida and Georgia show, there will always be the possibilities of new gaps opening in the system due to the vagaries of state budgets and politics.