Opponents of meds-for-meth bill hold teleconference

Since they were not given the opportunity to speak at last week's legislative hearing about a move to make pseudoephedrine available mainly by prescription, opponents held a teleconference yesterday to air their opinions. It was hosted by representatives of the Consumer Healthcare Products Association, which represents makers of over-the-counter drugs.

Pat Davis, mother of six and wife of 4th District U.S. Rep. Geoff Davis, said "Our children are going to miss school, parents are going to miss time at work," if a prescription bill passes. Davis said she was disappointed she'd not been given the opportunity to speak last week. "There wasn't a single dissenting voice to be heard," she said. Legislators said they ran out of time and opponents would be given a chance to be heard.

Dr. Donald Neel, an Owensboro pediatrician, said he "recommends pseudoephedrine daily because it is the only safe and effective drug that we can recommend over the counter." He added, "It makes absolutely no sense for patients who need pseudoephedrine to have to come to the office, to take time off work. And we don't have time to see them." Neel said he feels "97 percent of his patients use the medicine legitimately,"

The bill at issue would require a prescription for pills containing pseudoephedrine but would not apply to medications using gelatin capsules, which are more difficult to use in meth making.

State Rep. Brent Yonts, D-Greenville, sponsor of an alternaitve bill, said the prescription measure goes too far. "Who do we punish? The soccer moms? Or the criminals?" he asked. His bill would only require the 5,500 people who have been convicted of a meth-related crime to have a prescription. It would also lower the amount of pseudoephedrine people can buy from 9 grams per month to 7.5 grams. It would continue to track the drug using MethCheck, which instantly tracks purchases at the point of sale. He called his effort "a common-sense approach."

Law enforcement and some legislators have criticized Yonts' bill because it won't alleviate "smurfing,"  meth cooks' payment of others to buy pseudoephedrine for them. But Yonts said MethCheck requires people buying the drug to hand over their driver's license and be placed in the system, allowing law enforcement to track who buys it often. "When they see these repeated efforts, they're going to be tracked down," he said, adding 30,000 stores and pharmacies use the system nationwide. "it's the right solution for Kentucky, and we can block criminals from getting this," he said.

Expect a bill that will require doctors to have KASPER accounts, state drug policy director says

By Tara Kaprowy

Kentucky Health News

A bill is likely to be filed in the General Assembly that will require drug prescribers to have an account with the state’s drug monitoring system known as KASPER, news that was met with applause at the Different Faces of Substance Abuse conference yesterday.

“We’ve got to get KASPER out of the dark,” said Van Ingram, executive director of the Kentucky Office of Drug Control Policy. “Let’s take the guesswork out of this, and let’s use the data proactively.”

The bill would also propose using the Kentucky All-Schedule Prescription Electronic Reporting system to “mine data toward patients,” Ingram said, meaning analysts would look for people who have gone to an unusually high number of physicians or other providers within a short period of time, presumably to doctor shop for drugs.

Ingram said the KASPER Advisory Council, charged by Gov. Steve Beshear to identify prescribing thresholds in various medical disciplines, is discussing targeting providers who write 6,000 to 8,000 prescriptions a year — or the top 5 percent of prescribers. Kentucky’s Office of the Inspector General, which is in charge of maintaining KASPER, would find the information and refer it to the various licensing boards, which would then take appropriate action. The move is “quite a paradigm shift,” since it would be using data proactively, rather than reactively, Ingram said.

Since some providers aren’t in the same location for a year at a time, Ingram said the counsel will likely advise KASPER to be analyzed on a per-day basis, since many "problem prescribers are here for a day."

Dave Hopkins, KASPER program manager in the Office of Inspector General, said 6.6 percent of Kentuckians have used prescription drugs for non-medical purposes, second highest in the nation behind Oklahoma. He said 15,000 Americans die annually of overdoses involved in prescription drugs.

KASPER monitors all Schedule II, III, IV and V controlled substances that are dispensed in Kentucky, data that is required by law to be inputted by pharmacists and other dispensers. That translates to more than 11 million controlled substance prescriptions each year, Hopkins said.

To use KASPER, doctors and providers can request reports about specific patients and see their prescription history over the Internet. In 2004, 122,469 such reports were requested by providers. In 2011, that number jumped to more than 800,000. “When we started this in 1999, the Cabinet for Health and Family Services estimated there would be a maximum of 200,000 reports a year,” Hopkins said.

Still, while 95 percent of the reports were requested by prescribers, just 32 percent of them have KASPER accounts. And though pharmacies are required to input the information, just 26 percent of them have accounts.

Ingram would not say who would file a bill that would change those numbers, but he feels hopeful about changes to come. “I’m really excited for the first time in a long time that we’re going to get some things done,” he said.

Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.