'Pill-mill bill' showing progress, but officials say work remains to combat drug abuse in Kentucky
07/27/2015 07:27 PM
FRANKFORT – A state law targeting prescription drug abuse has shown signs of progress since its enactment in 2012, with fewer patients “doctor shopping” for pills and more physicians searching Kentucky’s narcotic drug database before writing prescriptions, according to a study released Monday.
Gov. Steve Beshear, flanked by Attorney General Jack Conway, Senate President Robert Stivers, House Speaker Greg Stumbo and other state officials, said the University of Kentucky Institute for Pharmaceutical Outcomes and Policy’s study covering July 2012 through March revealed 24 non-physician-owned pain-management clinics have closed; nearly 20,000 prescribers began using the Kentucky All Schedule Prescription Electronic Reporting system, which now boasts some 5 million queries each year compared to 800,000 annually; and patients identified as “doctor shoppers” dropped 52 percent since the General Assembly passed House Bill 1 during a 2012 special session.
“House Bill 1 is succeeding in creating a paradigm shift in the behaviors and attitudes of prescribers and patients alike – a shift that will pay off long-term,” Beshear said. “In this new environment, the decision to prescribe a pain killer has become more of a conscious, measured decision between a prescriber and a patient, with the dangers of addiction well-known and accounted for.
“Furthermore, most of those who were involved in this process out of greed and other reasons, such as certain pain clinics and other middlemen have been driven out of the commonwealth of Kentucky.”
After the legislature passed the so-called “pill-mill bill,” prescriptions for narcotic drugs dropped between 4 and 8 percent with a substantial increase in the use of KASPER, according to the UK study. KASPER-registered prescribers have jumped 262 percent, with registered pharmacists increasing 322 percent, the study found.
Concerns of a so-called prescription chilling effect since HB 1’s enactment are also unfounded with prescriptions for opioids typically used during cancer treatments increasing while those for oxycodone, hydrocodone and oxymorphone decreased, according to the report.
New KASPER-monitoring guidelines also created a new partnership between the Kentucky Board of Medical Licensure and law enforcement, which has received 211 referrals from the licensure panel since HB 1 became law, Conway said.
“We’re not hounding doctors, and for all those rumors where physicians thought the attorney general would be up late at night looking at their prescribing habits, that hasn’t happened,” he said.
“But what has happened is a culture shift amongst the board of medical licensure. In my first term as attorney general, we received zero referrals, zero referrals from the board of medical licensure. Now we are working with them to make certain that we ferret out the worst actors.”
On its own, the board has taken 196 disciplinary actions against 142 physicians, according to a news release.
Still, Beshear and others noted that more work remains as many Kentuckians remain addicted to illicit drugs, mentioning anti-heroin legislation passed this session.
Overdose deaths in general had leveled off in 2013 before ticking upward in 2014, with the study’s overdose data covering 2009 through 2013. Van Ingram, executive director for the Kentucky Office of Drug Control Policy, said prescription opioids are still main causes in overdoses here.
“Rarely is it just one drug that caused the death,” he said. “It was the combination of these drugs that caused the death, but the overwhelming majority of them, even still, have opioids in their system.”
Ensuring adequate addiction treatment is another issue troubling state officials. Stumbo, D-Prestonsburg, said the state’s need for beds in treatment centers far outweighs its current resources.
“It’s estimated in Kentucky that we may have as many as half a million of our fellow Kentuckians addicted to some form of drugs,” Stumbo said. “It’s estimated that maybe half of those would benefit, Ms. (Jane) Beshear, from treatment. We have less than 2,500 treatment beds in this state right now.”
Stumbo voiced support for a continual funding source for treatment centers, a recommendation made by a panel studying prescription drug abuse under former Gov. Ernie Fletcher on which Stumbo served.
For Stivers, recent sessions have shown how politicians of both political stripes have come together to pass substantial drug reforms.
“(Drug dealers) don’t ask you if you’re a Republican or a Democrat before they sell it to you,” the Manchester Republican said. “They just want to try to profiteer off the system. They don’t care about the heartache and pain they create for families, and we as the policymakers here in Frankfort know when it’s time to together and work on issues.”
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