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August 18, 2014

Drug abuse council backs automated analysis of pain pill data

The state’s prescription drug database in the future could be combed by a computer program to flag pain pill mills, but the use of that information also could be abused.

The state’s prescription drug database in the future could be combed by a computer program to flag pain pill mills, but the use of that information also could be abused.

The panel putting together the state’s first broad plan for dealing with prescription drug abuse decided Monday that computer analysis is important for the Prescription Monitoring Program, even as members said protections need to be built into the system.

Just because one physician prescribes a large number of pain pills doesn’t mean that physician has done something wrong. That’s why the computer analysis needs to be the start of a check, with the next step involving people with clinical knowledge, council members said. Law enforcement agencies should not have unfettered access to the data and should only get involved later in the process.

“I understand the concern about law enforcement’s involvement in the system,” said Patrick J. Maley, the state’s inspector general, “but law enforcement is at the caboose end on this data.”

Currently, law enforcement agencies have to approach the database managers, in this case the S.C. Department of Health and Environmental Control, with specific reasons for viewing data. For instance, they could do that when investigating potential pill mills – physicians or pharmacists that prescribe and/or dole out inordinate numbers of pain pills.

Those investigations now often start with complaints to DHEC or law enforcement agencies from employees in pharmacies or doctors’ offices or family members of drug abusers. Using an analytics program “in my opinion (is like) a higher level of complaints than what we get right now,” said Catherine Templeton, director of DHEC. “I don’t think there will be any individual liberties at issue here at all. ... We’re just using a resource we already have.”

Detailed information will be logged in the Prescription Monitoring Program each time certain classes of drugs are prescribed or purchased. That information will be compiled and available to registered physicians and pharmacists, who can use it to make sure patients aren’t going to multiple physicians to get multiple prescriptions for the same drug. Health care professionals using the database face felony charges if they go fishing around for information in the system about anyone other than their own patients or customers.

The Prescription Monitoring Program is in place already, but without the souped up computer analytics programs that can automatically flag potential abuse and show links between abusers and pill mills. Also, only about 20 percent of physicians are signed up for the program, and even fewer use it regularly.

A major component of the plan being put together by Gov. Nikki Haley’s Prescription Drug Abuse Prevention Council will be persuading more physicians to use the current system. Maley said a similar effort in Kentucky had unintended consequences. Unhappy with the way the system was set up, he said, physicians in entire counties stopped prescribing any opioid-level pain medications.

Haley’s panel aims to avoid that by bringing the major physician groups in the state into the planning process. Dr. Louis Costa, chief surgeon at Southeastern Facial Plastic/Cosmetic Surgery Center in Charleston, is co-chairman of the panel with Bob Toomey, director of the S.C. Department of Alcohol and Other Drug Abuse Services.

Costa acknowledged the concern about using high-end computer analytics on data from the Prescription Monitoring Program. But he said it can be a positive if it helps physicians recognize problems with patients abusing drugs, or prevents inadvertent over-prescribing of drugs.

“We endorse a system that gives us alerts not arraignments,” Costa said.

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