California prescription drug program needs a lifeline

Traditional police work wouldn't have nabbed Dr. Lisa Barden for visiting 43 pharmacies to illegally obtain tens of thousands of pain pills to fuel her own addiction.

In both cases, a computer database did the essential sleuth work. The program known as the Controlled Substance Utilization Review and Evaluation System has exposed so-called pill mills that also has led to dozens of convictions in prescription drug abuse cases.

Budget cuts now threaten the program's existence at a time when the U.S. government reported the number of overdose deaths from powerful painkillers more than tripled over a decade. Future criminal investigations into dirty doctors and those who shop for and sell prescriptions illegally would be severely hampered because information culled from pharmacies would no longer be updated, authorities said.

“It's like a spider web of information for law enforcement to start their investigations,” said Debra Postil, a Riverside County deputy district attorney who prosecuted Barden. “Without CURES you are going to have old-fashion detective work that won't be able to tell the bigger picture.”

A decision on whether the program will be spared will be made in the next several weeks, state officials said. Recently the staff overseeing the database has been cut from eight people to just two.

California has the oldest prescription drug monitoring program in the nation. Officials moved to an online tracking system three years ago where prescription information can be accessed by doctors, law enforcement officials and others to ensure patients aren't abusing drugs.

More than 8,000 doctors and pharmacists have signed up to use CURES, which has more than 100 million prescriptions, since 2009. The system also has been accessed more than 1 million times for patient activity reports.

In all, 37 states have prescription drug monitoring programs but California is the only one in jeopardy of not having an active database, said Jim Giglio, executive director of the Alliance of States With Prescription Monitoring Programs. The remaining states have either legislation pending for a program's approval or have approved legislation but the database is not up and running yet.

“It's a tool that's being widely used,” Giglio said. “Without it, maybe not today, but down the road I think you'll see higher rates of controlled substances diversion.”

Gov. Jerry Brown touted the CURES program several years ago when he was attorney general and under his stewardship high-profile probes were launched into the deaths of Michael Jackson, Anna Nicole Smith and actor Corey Haim.

The cases highlighted the difficulty of determining whether a doctor is violating the law and prescribing outside the course of normal medical practice.

Charges were eventually filed against two doctors and Smith's boyfriend-lawyer in connection with her death after the database showed the former Playboy Playmate was receiving myriad prescription drugs. A jury acquitted the trio of most to all of the felony counts and a judge dismissed two convictions, while reducing one to a misdemeanor.

No charges were ever filed against seven doctors who treated Jackson in an investigation led by the state's Bureau of Narcotic Enforcement, a unit that oversees CURES. However, a separate probe by Los Angeles police led to the arrest of Dr. Conrad Murray who is expected to be sentenced Tuesday after being found guilty of involuntary manslaughter.

But the loss of CURES would be detrimental to other agencies like California's medical board which can pull doctors' licenses if they are found to be in violation of state laws.

“The information obtained from CURES data allows the board to narrow in on any potential prescribing issues for the physician and proceed with developing its investigation, so the board can take the appropriate disciplinary action,” board spokeswoman Jennifer Simoes said.

In Barden's case, two prescriptions were left behind at a pharmacy in Riverside County and the person behind the counter believed they didn't belong to the woman trying to fill them. Using CURES, investigators learned Barden not only stole patients' identities but faked other doctors' signatures to score more than 30,000 painkiller pills.

“We wouldn't have had the big picture that we had,” without CURES, Postil said.

Barden pleaded guilty to more than 270 felony counts and was sentenced in January to a year in jail with a suspended eight-year prison term.

The database helped find that Al Bussam was the No. 1 prescriber in California between January 2008 and October 2010, issuing 78,000 prescriptions; the next highest prescriber doled out about 48,000 prescriptions.

Officials estimate it would cost less than a $1 million to run the database annually. The funding comes from the state and federal grants. CURES is part of a $71 million cut in the state Department of Justice budget over the next two years.

If public funding can't be found, a proposed ballot measure to impose a quarter-cent-per-pill tax on drug companies might save the prescription drug monitoring program.

Bob Pack, whose two children were killed in 2003 by a drunk driver high on pain killers, is spearheading the effort. California's Secretary of State this week cleared Pack to seek 504,000 signatures in order to qualify for the November 2012 ballot. The proceeds would then be funneled directly to the CURES program.

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