Fighting the pill scourge

It was cause for celebration in 1999 when Kentucky created a system to track prescriptions for potentially addictive painkillers. Prescription pill abuse was a real and growing problem and KASPER (Kentucky All Schedule Prescription Electronic Reporting System) offered a powerful tool in the battle against it.

The goal was to put an end to doctor-shopping, in which patients obtain overlapping prescriptions for painkillers from multiple physicians in order to abuse or sell the drugs, or both. A doctor could contact the registry before writing the prescription to learn what, if any, painkiller prescriptions the patient had already filled in Kentucky.

As we all know, prescription drug abuse has continued to grow in Kentucky. KASPER has been useful but recent reports show that only about 25 percent of physicians consult it before prescribing painkillers. Additionally, the data contained in KASPER has not been used effectively to address another aspect of the problem, physicians who criminally over-prescribe painkillers.

A proposal by House Speaker Greg Stumbo to move the KASPER system from the Cabinet for Health and Family Services to the Office of the Attorney General could go a long way toward making KASPER a more effective law-enforcement tool.

It's a commonsense move, placing KASPER in an agency that has a primary mission of law enforcement. The AG's office is also engaged in investigating and prosecuting Medicaid fraud, which is sometimes linked with prescription drug scams.

Stumbo has indicated he intends to offer wide-ranging legislation to attack prescription drug abuse. In that regard, we offer a couple of additional suggestions to make KASPER more effective.

■ There is debate about whether it's appropriate to use KASPER to find trends, such as geographic areas with a high volume of pain pill prescriptions or physicians or practices that write an especially large number of the prescriptions. Law enforcement agencies and licensure boards often must wait until they have a complaint about a specific prescriber before pursing information. The legislature needs to make it clear that it's appropriate to use the database to find violators, not just to make a case against them.

■ Provide a dedicated funding source for KASPER. A database is only as good as the software that runs it and the people who monitor it. Uneven, unpredictable or inadequate funding could diminish KASPER's usefulness. Prescription drug abuse costs untold millions in Kentucky each year, ranging from the expense to law enforcement, court and incarceration systems to the costs to medical and social services, not to mention the damage done to businesses and families. This is an investment that would easily pay for itself.