Beshear touts prescription drug abuse crackdown, doctors group concerned


by Joe Arnold

Posted on July 24, 2012 at 4:17 PM

Updated Tuesday, Jul 24 at 6:50 PM

FRANKFORT, Ky. (AP) --  Four days into the enforcement of Kentucky House Bill 1, the so called "Pill Mill Bill," Governor Steve Beshear said Tuesday the law has already prompted four pain management clinics to "wave the white flag" and shut down rather than comply with the new restrictions.

"If you're doctor-shopping, if you're acquiring pills for recreational use, if you're buying pills to sell, or if you're prescribing drugs recklessly for profit, we're coming after you, and we're coming after you hard," Beshear said at a capitol news conference.

The law is more than just "pill mills."  It also requires every medical provider – doctors, dentists, emergency rooms and hospitals -- to register with Kentucky All Schedule Prescription Electronic Reporting (KASPER), the state's prescription monitoring system, and run a KASPER report on a patient before prescribing a controlled substance.

"We lead the nation as most people know in cancer, heart attacks, a lot of other things that will require controlled substances," said Patrick Padgett, Executive Vice-President of the Kentucky Medical Association.  "So is there a problem? You bet there's a problem and we recognize that there's a problem.  But we believe that any law that's passed, any regulation that's passed, has to have a careful balance to recognize the realities of medical practice so that it doesn't impact the patient who legitimately needs pain medicine, ADHD medicine, or any other type of medicine that's a controlled substance.”

Beshear also tried to discharge any worries some might have about KASPER.

"If you need a prescription, you'll get your medicine," Beshear said, dismissing as "misinformation" concerns voiced by the KMA and other medical groups.  "If you prescribe with the right intent, you have nothing to fear."

"Not only do they have to query KASPER, they have to do a list of other things, a list of seven other things that they have to do before they can write that prescription," explained Padgett, "It's quite a bit, especially if you're laying there in the hospital."

The state counters that the checks are not cumbersome - 90 percent are completed within 15 to 30 seconds.  But when asked by WHAS11, Beshear acknowledged the KASPER computer system was out of service at times over the weekend just as the law went into effect.

"KASPER did go down over the weekend mainly because there was an unprecedented run by folks trying to get registered at the last minute and it caused it to go down," Beshear said.

Yet the governor said the system allows for a provider to "use their best medical judgment" and prescribe a controlled substance if the system does not provide a report in a timely manner.

"Folks will not be denied their medicine when they really need it," Beshear said.
"What it is going to do is require a doctor to do a simple check and find out if a guy has just been around a corner yesterday getting two other prescriptions for the same drug," he said.

"This will give doctors the opportunity to take a look at themselves and say, 'Am I overprescribing, what are the standards?'" added Attorney General Jack Conway (D) in an interview.  "And we need standards here and I think that's going to have to be a dialogue that takes place between the Board of Medical Licensure, the KMA and practitioners throughout the state."

WHAS11 asked Beshear if he believes that legitimate doctors are overprescribing controlled substances and will learn that as a result of the KASPER system.

"Yes," Beshear replied.  "You don't prescribe 219 million doses of hydrocodone, equal to 51 doses for every man, woman and child, that's not only coming out of pain clinics."

"[Kentucky doctors] would like to see better data, they would like to have the reports instantaneous," Padgett explained.  "They would like to have the reports real time.  And when that happens I think it will be a very, very effective tool for physicians even more effective than it has been.