Summit looks at solutions for prescription pill abuse
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Overdose deaths from narcotic medications are double those from cocaine and heroin combined, but concerned doctors and pharmacists in Pennsylvania don't have the tools to stop the flood of pills, participants in the Western Pennsylvania Prescription Drug Abuse Summit said Wednesday.
While the state has a system for reporting narcotic prescriptions, it can't be viewed by the very medical professionals who control the drugs. Only law enforcement agencies, the last line of defense against misuse of medicines, can see who prescribed what to whom.
"I think Pennsylvania's [prescription monitoring] program could be vastly improved," said Regina Labelle, a deputy chief of staff for the Office of National Drug Control Policy, as around 200 doctors, pharmacists and law enforcement officials listened at Washington & Jefferson College's Olin Fine Arts Center. "The legislature just needs to take the steps to improve it."
That was a recurring theme at the first-in-the-region summit, hosted by U.S. Attorney David Hickton, whose office has prosecuted a series of links in the supply chain that puts prescription drugs in the hands of abusers. "I'm hearing an appetite for a solution, and I'm hearing dimensions of a problem that may be even bigger than we realized."
Ms. Labelle painted the big picture: 15,600 overdose deaths from opioid painkillers in 2009, versus 7,000 from heroin and cocaine combined, and pills challenging marijuana as the top gateway to hard drug use.
Assistant U.S. Attorney Steve Kaufman and Senior Deputy Attorney General Jeffrey Baxter illustrated the local supply chain, describing prescription-flipping doctors in New Castle and West Mifflin whose waiting rooms were jammed with addicts, until they were prosecuted for dispensing medicine without legitimate medical purpose.
The prosecutions won't end the problem, Mr. Kaufman said. "Other doctors, for whatever reason -- money, sex, whatever reason -- will spring up."
Phil Bauer of York spoke before a slideshow of his basketball-playing, weight-lifting son, Mark. He described at length their warm relationship, and in brief the discovery of his child's lifeless body, and the bag of 117 pills of seven different kinds beside the bed, just days before he would have graduated from high school.
"We need to be pissed off," said Mr. Bauer, who lectures widely about the subject. "We need to be scared."
He said he detected at the summit a refreshing inclination toward action and urged, "Please hurry up."
Pennsylvania pharmacies report the prescriptions they fill for the most powerful narcotics into a state pharmaceutical accountability monitoring system. But the database that shows who is getting which medicines isn't available to doctors or pharmacists, so they have no objective way of identifying patients who are tapping multiple providers for drugs.
"When can we see that we can have access to this important tool?" one doctor in attendance asked.
Legislation by state Rep. Gene DiGirolamo, R-Bucks, would expand the reporting of prescriptions to the state, and allow doctors to query the system and find out whether their patients are getting drugs elsewhere. The legislation was put on the back burner, though, in February.
Ms. Labelle said strengthening prescription drug reporting is a top administration priority, but it can only be achieved by the states. Kentucky, she said, has the best program, which requires that doctors check their patients' drug history before prescribing narcotics.
Even without access to a prescription database, doctors and pharmacists should do more to control the flow of pills, summit participants said.
"Why are [emergency rooms] writing for Vicodin when they could've written for 800 milligrams of ibuprofen?" said Cathy Fitzgerald, a pharmacist.
A doctor in the audience added that some of her colleagues seem to treat drug addiction by doing little more than addicting the patient to a different drug, buprenorphine.
Buprenorphine has come to be known as prison heroin, said Robert L. Hill, chief of the Drug Enforcement Administration's Pharmaceutical Investigations Section. It's a drug of last resort for addicts, who prefer oxycodone and hydrocodone products, and combinations of drugs known as "cocktails" that together pack a kick that none can alone.
Opana is "the new king of the streets," according to Neil Capretto, medical director of Gateway Rehabilitation Center in Aliquippa. Coming soon is Zohydro, a new pill that's expected to contain 20 times as much hydrocodone as Vicodin.
Mr. Hill said pharmacists can detect abuse when they see patients coming in with prescriptions for the drugs that go into the cocktails, and can report that to authorities. Medical privacy laws, he said, don't apply when the drugs have no legitimate medical use.
Parents also have a role.
"Storage of your medicines is very important," Dr. Capretto told around 100 attendees at an evening session for the general public. "To have these [narcotics] in your house is, in my opinion, like having a loaded gun."
First Published June 28, 2012 12:00 am