Dr. David Sack- CSMonitor.com
June 28, 2010
Michael Jackson: Prescription drug abuse a major lesson
By Daniel B. Wood and Gloria Goodale
It’s been a year since Michael Jackson’s death from a powerful,
doctor-administered anesthetic put the world spotlight on prescription
drug abuse. But most analysts, academics, and patient advocate groups
feel very little has been done to change the rules and procedures
governing such drugs.
“Since Michael Jackson’s death, this problem has grown in the US,”
says Dr. David Kloth, board member, past president, and national
spokesperson for American Society of Intervention Pain Physicians
(ASIPP). “Celebrities are unfortunately good for this issue because they
bring much needed attention to it.”
One big problem, say Kloth and others, is that the regulation of medicine and prescription writing is constitutionally a state matter, which creates a lack of uniformity and loopholes.
Along with the North American Neuromodulation Society – which represents 4,000 physicians – ASIPP is converging on Capitol Hill June 29 to push for wider prescription drug abuse monitoring.
ASIPP says more than 20,000 people die each year from prescription-drug
overdoses, spurred by the growth of “doctor shopping” in which patients
request care from multiple physicians, often simultaneously and across
state lines, with no effort to coordinate care or inform the physicians
about multiple caregivers.
“The lack of uniform state regulation of the prescription drug industry
is to blame,” says Ron Washburn, professor of legal studies at Bryant
University. “More and more instances are arising where an individual can
see multiple doctors and get multiple prescriptions to either use or
sell.”
One important move forward, say analysts, is the trend towards making
patient databases instantly available. A federally-funded California
program pushed forward by Attorney General Jerry Brown in the wake of
Jackson’s death, as well as those of Britany Murphy, Anna Nicole Smith,
and Heath Ledger, was unveiled in the fall of 2009.
Brown unveiled the new real-time, Internet-based prescription-monitoring
database that provides physicians, pharmacists, and law enforcement
officers a powerful technology to stop "drug seekers" from obtaining
prescription drugs.
"The recent deaths of Anna Nicole Smith and Michael Jackson have made
clear to the whole world just how dangerous prescription drug abuse can be,"
said Brown at a press conference.
The state's secure database, known as the Controlled Substance
Utilization Review and Evaluation System (CURES), contains more than 100
million entries representing controlled substances dispensed in
California. Controlled substances are classified under federal
guidelines based on the potential for abuse and accepted medical use in
treatment in the United States and under international treaties.
The database gives health professionals (doctors, pharmacists,
midwives, and registered nurses), law enforcement agencies, and medical
profession regulatory boards instant computer access to patients'
controlled-substance records. It replaces the state's previous system
that required mailing or faxing written requests for information. Each
year, more than 60,000 such requests are made to the Attorney General's
office.
Those desiring access must undergo a strict registration process, points out spokesperson, Christine Gasparac, who adds there are currently 2,442 physicians and 935 participating pharmacists.
To get more action nationwide, patient advocates and doctors urge
citizens to write their state medical boards asking them to explore and
require additional education and training. A lot of the public anger
that coalesced after Jackson’s death became directed at his doctor, Dr.
Conrad Murray, who was charged with involuntary manslaughter related to
Jackson’s death. Courts have refused to revoke Murray’s professional
license.
“There is precious little training in most medical schools so that
most non-specialists really don’t know how to prescribe and administer
these drugs,” says Dr. David Sack, CEO of Promises Treatment Centers,
which specialize in treating a wide variety of addictions, such as
prescription drug abuse and marijuana abuse.
More training is imperative, says criminal lawyer Elizabeth Kelley, who points out that addiction is an illness.
“Once patients have become addicted, doctors need to understand just how manipulative and determined these individuals are,” she says adding, “they will do whatever it takes to get their hands on drugs and doctors need to be more prepared to deal with this.”