Legislature should crack down on pill mills

A survey released last week found that almost a third of Kentucky adults knew a family member or friend who had abused prescription pain relievers. In Eastern Kentucky the incidence rose to 43 percent. Statewide among young adults, aged 18 to 29, close to half, 44 percent, knew someone who had struggled with pain pills.

Surprised? Perhaps not. Alarmed? Absolutely.

The cascade of stories never seems to stop about pill mills, the pill pipeline to Florida and other states, children neglected in homes where adults are addled by pills, courts and prisons clogged with drug offenses, thieves stripping copper from power lines and other crimes driven by the need to buy another pill.

So, no, we shouldn't be surprised that so many Kentuckians have seen problems from abuse of pain pills up close.

But we can't allow familiarity to dull our alarm. As the incomplete list above indicates, the damage done by prescription drug abuse extends far beyond the individuals involved.

Law enforcement will never be the final answer to drug abuse of any kind. It's a problem that grows out of poverty, despair, illness and lack of opportunity. Addressing those problems, like so many others in Kentucky, means taking on the long-term commitment to improve access to education, health care and economic opportunity.

Still, there are things that can, and should, be done legislatively in the short-term to make it harder for pill pushers to stay in business in Kentucky and, therefore, limit access to prescription pain pills for people who aren't in medical need of them.

Some local communities this year took the initiative to outlaw pain clinics to protect themselves from becoming hosts to pill mills, where doctors sell access to prescription narcotics after cursory or non-existent examinations. But for legal and logistical reasons this is a problem that needs to be addressed at the state level. Some simple changes in licensing requirements for pain clinics could protect legitimate medical practices and discourage pill mills. Among the fixes that seem reasonable are requiring criminal background checks of people planning to open pain clinics, barring convicted felons, and requiring that a physician working at a pain clinic have an ownership interest in it. Sen. Jimmy Higdon, R-Lebanon, has prefiled a bill that includes these and other requirements.

Last summer an issue arose about whether KASPER, Kentucky's system for tracking pain pill prescriptions, is being used effectively to find and discipline physicians who over-prescribe. As often happens, the story became mired in a finger-pointing contest between two state agencies — the Cabinet for Health and Family Services, which maintains the KASPER system, and the Board of Medical Licensure which investigates and disciplines doctors — about where the gaps in the system lay. In November Gov. Steve Beshear appointed a panel to develop guidelines to solve this problem and improve KASPER's effectiveness as a tool to stop pill-pushing medical renegades without damaging the practice of legitimate physicians.

Let's hope the panel makes recommendations soon so that the Kentucky General Assembly can move quickly to address both of these issues in the upcoming session.