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Danville family advocates of drug monitoring

By Jeanine Benca
Contra Costa Times
September 15, 2009

California doctors, pharmacists and some members of law enforcement soon will be able to access any patient's prescription drug history with the click of a mouse.

Today's ?planned announcement by state Attorney General Jerry Brown's office of a new "real-time" prescription drug monitoring system in California comes on the heels of the most high-profile prescription drug death of all time — that of music icon Michael Jackson.

Authorities last month ruled the singer's death a homicide after it was determined he likely died of a lethal mix of sedatives and the surgical anesthetic Propofol. Brown's office is investigating several doctors in connection with the case.

A year and a half before Jackson, actor Heath Ledger died of a toxic combination of prescription drugs.

Brown, a former governor and likely gubernatorial candidate in 2010, is expected to give details of the program at a Department of Justice press conference, set for 11 a.m. today at the Reagan Building in Los Angeles, department officials said.

The aim of the new system is to cut down on doctor shopping among drug abusers, said Katherine Ellis, a manager with the California Bureau of Narcotic Enforcement. "The goal is to get the individual off their addiction."

Doctors, pharmacists and investigators with open cases have long had access to Justice-maintained patient records under California's 70-year-old prescription drug monitoring program.

However, they must fax their requests and returns can take days or weeks.

Supporters say the online system, which has been in the works for six years, will be of particular help to emergency room doctors who usually have to make fast decisions about whether to prescribe drugs.

However, it could also raise alarms among privacy groups and pain prevention advocates who have fought similar programs in other states. A spokesman for the Privacy Rights Clearinghouse, a national privacy advocacy group based in San Diego, declined to comment Monday, saying more details about the program were needed.

California's system will not be the first real-time system, but it will be the largest. Other states with Web-based programs include Kentucky, Maine, Ohio, North Carolina, Tennessee, West Virginia, Illinois and Virginia.

Most other states have some form of prescription drug monitoring, though efforts to monitor drugs have been met with resistance in some. Privacy groups fought efforts in Florida, which only recently received state approval to start a drug monitoring system after years of failed attempts.

Among the speakers at today's press conference today will be Bob Pack, a Danville activist who helped fund and develop the program.

Pack's children Troy, 10, and Alana, 8, were struck and killed on a Danville sidewalk in October 2003 by a driver who had been drinking and taking prescription drugs.

At her trial, it was revealed that Jimena Barreto had received multiple Vicodin prescriptions within days of each other. Kaiser Permanente doctors who had prescribed the drugs testified that they were unaware she had been given multiple prescriptions.

"I said, 'How could this be?" he said.

Pack teamed up with Kaiser officials and then-state Sen. Tom Torlakson on a bill allowing development of the real-time system, which initially was met with concerns by privacy groups and others. In response, Pack's nonprofit group, the Troy and Alana Pack Foundation, and Kaiser Permanente funded a feasibility study that examined how privacy would be protected under the system.

Users will have to apply for access to the system. After their identities are verified by the Department of Justice, they will be issued unique passwords, Ellis said.

Narcotics officers at local police agencies who routinely conduct investigations will be able to apply for passwords, but patrol officers generally will not be granted access, she emphasized.

Unauthorized use of passwords and medical records would come with serious sanctions, she added.

Pack, who has a background in technology and helped develop the program, said it employs "bank-level" security.

Dr. Scott Fishman, chief of pain medicine at UC Davis, has been a longtime supporter of the program.

Far from "targeting pain doctors" — a concern that has been voiced in Florida and other states that have struggled to strengthen prescription drug monitoring laws — the system will make doctors' jobs easier by giving them more insight into their patients, he said.

"The prescription drug abuse problem can't be overstated. It's growing in very concerning ways," he said. "Many doctors may oppose this because they think it's another form of Big Brother watching. But I think once they see what this does is put the information in their hands "... it will be more of a benefit to them."

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