Politics & Government

Unmonitored pain clinics may lead to more deaths, officials say

A Kentucky State Police sergeant noticed a silver Chevy Cavalier weaving on I-75 near Richmond, Ky., last week and pulled it over.

The driver said she was returning home to Kentucky from Florida with her friend, who was asleep in the back seat.

But Lisa Rogers, 42, was dead.

An apparent drug overdose, said state police, who suspect she took a lethal dose of prescription narcotics obtained from pill mills in Florida.

Her daughter thinks so, too. Every month, Rogers got a ride to Tampa and Fort Lauderdale to load up on OxyContin and Xanax for herself and also to sell, said 18-year-old Brooke Frailey. Rogers favored Florida, her daughter said, because of its many pain clinics and because it doesn’t have an online monitoring program that alerts doctors and pharmacies to drug-shoppers like Rogers.

“In 2009, we arrested over 500 people from eastern Kentucky who’d gone to Florida to get around our prescription drug database,” said Trooper John Hawkins, a spokesman for the Kentucky State Police. “Until there’s a monitoring program in Florida, they’ll keep coming.”

After seven years of debate, the Florida Legislature approved a monitoring system in 2009 that was set to start operating this year. But Gov. Rick Scott wants to repeal it, citing concerns about patient privacy, paying for the system, and how effective it would be.

He hasn’t talked about his objections in detail; his desire to repeal the program was buried in his 800-page budget proposal.

Scott’s spokesman, Brian Burgess, did not return phone calls seeking more details.

But 34 states already have such programs up and running and say they don’t have the kind of problems Scott fears. Some say the real concern is that Florida, where an average of seven people die every day of prescription drug abuse, will continue to be one of the states without a database.

“I don’t think your governor understands the impact Florida’s pill mills are having outside the state,’’ said Kentucky Lt. Gov. Daniel Mongiardo.

“If there’s no prescription drug monitoring program in Florida, I’m toying with putting a billboard just over your state line that says ‘Welcome to the Oxy-tourism Capital of the World.’”

Bruce Grant, who led the Florida Governor’s Office of Drug Control under former governor Charlie Crist, said care was taken to address concerns in the three areas Scott has cited.

His office secured $1.2-million from nonprofits, private donations and federal grants so state money would not be used. As for privacy, the information in the database would be protected under the federal Health Insurance Portability and Accountability Act, which safeguards patient confidentiality.

Chris Baumgartner of the Alliance of States with Prescription Drug Monitoring Programs said the 34 state programs all have “a very good track record’’ for privacy and cost control. On average, the programs cost $500,000 a year to operate, he said.

The Florida program was modeled after Kentucky’s, widely regarded as one of the best in the country. Van Ingram, director of the Drug Control Office in Kentucky said since the database started in 1999, complaints about confidentiality have been “extremely rare.” In Kentucky, as in the proposed Florida program, law enforcement cannot check people in the database unless they are already under investigation.

As for funding, after eight years of being supported with federal grants, Kentucky took over paying for the database because it was so popular.

But Ingram conceded that it’s difficult to measure effectiveness. Prescription-drug-related deaths in Kentucky increased slightly last year, but that doesn’t mean the database isn’t working, he said.

“Citizens in Kentucky wouldn’t be driving 800 miles to Florida to get prescription drugs if they could get them here,” he said. “You have a beautiful state full of sunshine, but that’s not the big draw.”

Dave Hopkins, director of the Kentucky database, pointed to a 2010 survey of medical professionals who use the system: More than 96 percent said they thought it was “very effective” or “somewhat effective.”

Oklahoma started the nation’s first prescription monitoring program in 1990.

Initially, people “worried that Big Brother would get in their business,’’ said program director Larry Carter. “But that fear has disappeared over the years.”

How effective is it? “In 1990 we were overwhelmed with prescription forgery and fraud. But after the first year of the program, it practically dried up.”

The Ohio Automated Rx Reporting System began in 2006, also amid privacy fears that have evaporated, said administrator, Danna Droz.

Like Florida’s proposed system, Ohio does not force doctors to participate. But increasingly they are, and that’s proof of its effectiveness, she said.

The system receives an average of 4,000 hits a day from doctors or pharmacists entering information or checking a patient’s prescription record. Droz says the system helps people with a legitimate need for pain pills since it shows they’re not abusers.

Droz says Ohio drug abusers go to Florida to buy pain pills.

“I was so hopeful that Florida would get a monitoring program,” she said, “not only for them but for us.”

Fasano, a Republican from New Port Richey, has been trying to get a monitoring program in Florida since 2003. The bill was finally signed into law in 2009, only to be held up by bid protests. Then, Scott proposed that legislators repeal it before it could even begin.

“That program has not been working,’’ Scott said last week, adding that he is working with Attorney General Pam Bondi to address the problem of pill mills.

Bondi, however, sees the monitoring program as “a great tool if run properly,’’ said her spokesperson, Jennifer Krell Davis. “No one is questioning that these programs help,” she said.

Up in Kentucky, Brooke Frailey buried her mother on Friday.

“If there was a program in Florida,’’ Frailey said, “my 16-year-old brother and I would probably still have a mother.”