Landmark Prescription Drug Bill Takes Effect; Gov. Beshear Praises Full Throttle Attack on Prescription Abuse

Office of the Attorney General
Landmark Prescription Drug Bill Takes Effect; Gov. Beshear Praises Full Throttle Attack on Prescription Abuse

Press Release Date:
Tuesday, July 24, 2012

Contact Information:
Kerri Richardson
502.564.2611

Just days after a landmark prescription drug abuse law took effect, Governor Steve Beshear joined lawmakers and medical providers to report the law has already effected changes in the medical field and positioned Kentucky as a national leader in battling prescription abuse.

House Bill 1 (HB1), sponsored by House Speaker Greg Stumbo, passed in a special legislative session this spring. The bill included multiple elements to prevent the abuse and diversion of prescription drugs and to enhance law enforcement’s tools to investigate illegal prescribing practices.

“The enforcement of this bill began just a couple of days ago, and yet we already know that four ‘pain management clinics’ in Kentucky have waved the white flag and notified us they will shut their doors,” said Gov. Beshear. “We know that more than 9,000 medical providers have signed up for electronic prescription monitoring just since this law passed in April – more than doubling the number registered. The word is out. Kentucky is deadly serious about stopping this scourge of prescription drug abuse, and now we have some of the strongest tools in the country to make that happen.”

Gov. Beshear was joined by Attorney General Jack Conway as well as representatives from medical licensure boards, advocacy groups and law enforcement organizations, for today’s announcement.

HB1 expands the Kentucky All Schedule Prescription Electronic Reporting (KASPER) system, the state’s prescription monitoring system, by requiring all prescription providers of controlled substances to register. It requires pain management clinics to be owned by a licensed medical practitioner, and requires professional licensure boards to investigate prescribing complaints immediately. The legislation allows for better coordination between health regulators and law enforcement to address problems of abuse. Finally, elements of HB1 will help prevent Kentucky from becoming a source state for prescription pills.

According to Kentucky’s Drug Control Policy Office, nearly 1,000 Kentuckians die every year from drug overdoses – an annual fatality rate that exceeds deaths from car accidents. More than 5,000 overdose patients are admitted to hospitals annually.

“Let’s be very clear – if you need a prescription for a controlled substance for a legitimate medical condition, you have nothing to fear. You’ll get your medicine. For doctors who worry their ability to prescribe will be compromised, you have nothing to fear. The law is built to protect valid prescribing,” said Gov. Beshear. “But if you’re doctor-shopping, buying extra pills for recreational use, or prescribing pills for cash, you’d better change your vocation or change your location, because we’re coming after you.”

“Prescription drug abuse is killing Kentuckians. Three people will die today from prescription drug overdoses. I believe the provisions in House Bill 1 will save the lives of our friends, our neighbors and our family members,” said Attorney General Jack Conway. “The provisions in this law will help shut down rogue clinics and providers who are poisoning people. I appreciate those in the medical community who have joined with us as responsible providers to be a part of the solution instead of part of the problem.”

“House Bill 1 and the emergency regulations will help stop tragic loss of life to drug abuse. We are working closely with medical professionals to ensure that legitimate pain management cases are not adversely affected,” said Speaker Stumbo. “The joint Implementation and Oversight Committee will be alert to any needed corrections, and we will make sure that all concerns are addressed.”

Lawmakers praised the cooperation of the Cabinets, agencies, and boards who worked together to create new regulations, educate patients and medical providers, and build the necessary computer infrastructure to support the implementation of the law.

HB1 Impact – KASPER enhancements

Effective July 20, all medical practitioners who prescribe controlled substances must register to use KASPER and run a KASPER report before prescribing a patient a controlled substance such as Oxycontin or Xanax.

When the law passed in April, KASPER had 7,911 registered accounts. Since then, another 9,137 providers have signed up for the program, a 115 percent increase.

According to the Cabinet for Health and Family Services (CHFS), which oversees KASPER, 90 percent of all KASPER reports are completed within 15 to 30 seconds. The reports show medical providers what other controlled substances have been prescribed to a patient and in what amount.

“Some providers worried that running a KASPER report would be cumbersome or time consuming, but 9 times out of 10, it will take as much time as measuring a patient’s blood pressure or recording their insurance information,” said Mary Begley, CHFS Inspector General. “It’s a very short investment of time that will become as routine as taking a patient’s temperature. A report can provide crucial information that not only may flag a problem user, but may also warn a provider of otherwise unforeseen complications from drug interactions.”

KASPER’s cache of prescription information will grow more robust as more users add records. Supporters say patient care will become more precise as medical providers review patient prescription history and know more about existing prescriptions.

A 2010 CHFS poll of KASPER users noted that 94 percent of medical providers said that the program is an effective tool in tracking an individual’s prescription history, and nearly 94 percent reported satisfaction with the tool. Nearly 9 in 10 KASPER users reported denying a prescription for a controlled substance to a patient based on information provided by a KASPER report.

To accommodate the steep increase in KASPER use, CHFS has hired additional staff, implemented system upgrades and expanded capacity.

Existing regulations provide that all dispensers (usually pharmacists) report to KASPER when any Schedule II through Schedule V controlled substances are dispensed. For the first time, new regulations provide that all prescribers must request a KASPER report before Schedule II, III and some IVs are prescribed. A list of certain Schedule IV controlled substances, which are known to be used or diverted, is attached.

HB1 Impact: Shared Investigative Information

HB1 requires that when a complaint about prescription abuse is lodged with any of several investigative agencies – the Attorney General, Kentucky State Police (KSP), CHFS, or any of the professional licensure boards – that complaint must be shared with the remaining agencies.

Previously, if KSP was investigating a possible pill mill, the agencies that licensed that clinic were not required to be notified, nor would they be compelled to contribute information to the case.

The Attorney General, KSP, CHFS and the six professional licensure boards have signed a memorandum of understanding to notify the other agencies of prescription complaints within three days of receipt. This will allow the investigators to share information quickly.

The six professional boards – Medical Licensure, Nursing, Dentistry, Pharmacy, Podiatry and Optometry – are required to share reports with the Attorney General, KSP and CHFS but not required to share among each other. This alleviates concerns that the professional organizations would be forced to report information to other boards that have no jurisdiction over the complaint.

HB1 Impact: Regulations Squeeze Offenders, Offer Grace Period for Providers

Regulations for the implementation of HB1 were filed on July 20, the effective date of HB1. These regulations, which interpret how the law is carried out by each agency, board, or office, uphold the intent of HB1 – to reduce the abuse and diversion of prescription drugs.

New regulations mandate that all pain management clinics must be owned by a licensed medical provider or employ a medical director in good standing with one of the professional licensure boards. Clinics will have some time to meet those requirements, but CHFS administrators say that already, four of the state’s pain clinics not owned by physicians have reported that they will close their doors. Another 9 have not yet contacted CHFS regarding licensing, and will be investigated to determine if they are operating illegally.

“Not all pain management clinics are abusing their prescribing authority – many of them are meeting legitimate patient needs,” said CHFS Secretary Audrey Tayse Haynes. “However, these regulations are designed to make it very, very difficult to stay in business if your clinic is a pill mill, prescribing high volumes of powerful drugs to people who are addicted.”

Each of the professional license boards has also created an educational period for practitioners through October 1st. Much like other laws such as the seat belt law, providers will have a few months to get accustomed to the new practices before any disciplinary action will take place.

“We don’t want the medical community to be afraid of immediate repercussions if they make an error this early in the process,” said Preston Nunnelley, chair of the Board of Medical Licensure. “We’ll have a few months to learn how the new policies will work, and we’ll be able to correct and guide providers along the way, instead of punishing people for unintentional errors.”

Let’s clear up some myths about cannabis

Ron Moore Published: July 20, 2012 12:00AM

 

Ron Moore Acebass

Aside from the American family, the one big loser in the prohibition of cannabis has been the truth. The fact that cannabis is illegal and the ramifications of even admitting you smoke it could jeopardize your employment, your standing in the community, your entire life. All of this, while the agents of misinformation spread their lies.

As a young airman I smoked cannabis while serving in Thailand. I found it to be something other than what I had thought it would be but nothing as harmful as I had heard. Back then there was so much misinformation. Over the years I have smoked off and on but it wasn’t until I met Gatewood Galbraith back in 1990 that I realized just how much I had been lied to.

The problem over those years is no one could speak up. No one dared to, except a handful of activists and over a period of 18 months things changed. The genie was out of the bottle and all the establishment could say is, “It’s a gateway drug.” By then that argument didn’t hold water and since then no one has been able to come up with a good enough reason for the prohibition. It’s as if they have been afraid of the debate, running from it from the president on down.

All we ask is for an honest and open debate. We have heard the concerns of those on the other side and we have answers for you. We want to take this past the Cheech and Chong persona of the cannabis culture. Our evidence is compelling if we can ever get a fair and impartial hearing unlike I have seen lately even in this very paper. The stereotypical “stoner” portrayed in a cartoon with misinformation and innuendo masked as an editorial. This does nothing to further the debate.

To our law enforcement community, whose concerns are that they would have a hard time identifying the medicinal hemp from industrial, I would first of all like to assure them that once the “Gatewood Galbraith Medical Marijuana Memorial Act” is signed into law there will be no need for you to worry as all cannabis will be legal. There would be no reason for you to have to make that call. Cannabis, however, is very easy to detect one from the other. Industrial hemp is grown in dense crops while medicinal is grown with the plant isolated from the male to ensure a high THC content.

The Family Foundation has voiced its displeasure but from their responses I can tell they just need to be educated as well. Cannabis is being proven to be a medicine all across the world. Countries such as Spain, Portugal, and Israel all have done remarkable research. Portugal has gone as far as legalizing and regulating all drugs, treating them on an individual basis, with great success. The folks at the Family Foundation question the motives of Sen. Clark and commented they feared it would be used as relief for jet lag and stress. What I would ask is what do doctors prescribe now for these ailments and if cannabis is deemed a viable cure then why shouldn’t my doctor prescribe it? If the war on drugs has been so good for the family then why haven’t the figures of abuse changed since Nixon first declared a war on cannabis?

The fact is we need to take another course. We need to take a long hard look at this war on cannabis; this war on the American family, this war that has torn this country apart. We can no longer afford to chase down every grower in Kentucky; cannabis will never be eradicated. We imprison more of our citizens than any other country on earth and we call this the land of the free. The drug war is financing our current industrial prison complex. Nothing good has come from it.

“Education Summer” is designed to educate Kentucky about the truth concerning cannabis hemp, the plant that our state depended on for so many years. We are getting the conversation started with volunteers all over the state. The facts are there. Before you judge someone unjustly, do the research and find out for yourself.

Ron Moore is director of the Kentucky Veterans for Medical Marijuana.

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