WASILLA -- Old-fashioned police work made the case against a North Pole man selling prescription painkillers to Fort Wainwright soldiers.
But some say a fledgling statewide prescription-drug database could stop such crimes in the future by allowing pharmacies to ferret out overzealous providers and drug-seeking patients.
Clifton Gaines, 44, in 2007 sold oxycodone, methadone and hydrocodone pills to an undercover Army investigator from the YMCA shuttle van Gaines drove, according to court documents filed in Fairbanks. Pill bottles in the van had Gaines' wife's name on them. He pleaded guilty Jan. 26 to two drug charges in exchange for a 15-year sentence, public defender Justin Racette said.
Gaines got his pills via legitimate prescriptions, investigators say, but got so many it's likely they came from a number of different providers.
"If we had a database it would sure help out, since this prescription drug problem is increasing big time," said Alaska State Troopers Sgt. Scott Johnson, who heads up the Fairbanks drug unit. "We're buying more prescription pills than we are coke or meth. It's horrible. It's big money."
Under a 2008 Alaska law, most pharmacies filling prescriptions for abuse-prone drugs such as oxycodone or morphine will have to enter them into a statewide database. The law mandates participation from nearly 400 pharmacies and more than 800 pharmacists in and out of state. State officials waiting on a $400,000 federal start-up grant say 2011 is the soonest the program would go into effect.
Supporters say the database won't stymie legitimate users.
Instead, they say, it will stop rogue doctors from handing out pills too freely and abusers from "doctor shopping" -- going from provider to provider for multiple prescriptions.
"If a person is multi-sourcing, this monitoring program would certainly nip it quickly in the bud, whereas now it might take months or years," said Wasilla pharmacist Mary Mundell, president of the state's pharmacy board, which will oversee the new database.
Prescription drugs factored prominently in the December arrest of Sherry Johnston, a story that made national headlines because the 42-year-old Wasilla woman is the mother of Levi Johnston, the 18-year-old father of Gov. Sarah Palin's new grandson.
Mat-Su drug investigators say Sherry Johnston sold OxyContin pills to informants in the parking lot of Wasilla's Target store, according to court documents. She has pleaded not guilty to felony drug charges and has not been convicted of any crime.
OxyContin -- the trademarked, time-release form of generic oxycodone -- is one of the most popular prescription drugs among abusers and traffickers, drug investigators around the state say. Users seek a euphoric high similar to heroin, only easier to get and less stigmatized.
It's a pricey high. Oxy sells for anywhere from $80 to $120 for an 80-milligram pill, drug investigators say. One tablet sold legally costs about $10.
Statewide, the Alaska State Troopers reported in 2007 they seized more than 2,100 tablets of OxyContin or oxycodone, up from 435 in 2005. At one 2007 Mat-Su bust alone, investigators seized 300 pills valued at $12,500.
Still, not everyone likes the idea of a statewide drug database.
The governor, for one, allowed the database law to hit the books last fall without her signature.
Palin, in a June letter to bill sponsor and then Senate President Lyda Green, praised the program's intent but expressed concern about potential privacy invasions, citing testimony from providers who said patients might delay care "because of this perceived intrusion upon their privacy."
"While the bill does much to protect the information in the database, and to punish persons who wrongfully access it, no system is perfect," the governor wrote.
She called on legislators and agencies to make sure privacy safeguards are achieved.
State officials say they addressed privacy concerns in several ways.
Law enforcement officials looking for a suspect on the database will need a judge to issue a search warrant or court order, said Brian Howes, senior investigator for the state Division of Corporations and Professional Licensing. Program managers will purge the prescription data after two years, Howes said. Someone who breaches database privacy faces criminal charges, Green wrote Palin in a response to her June 2008 letter.
The state stands to save money once the database is under way, officials say.
Alaska in the last fiscal year paid out $4.3 million in Medicaid claims for opioid analgesics including oxycodone, said Dave Campana, the state's Medicaid pharmacy program manager.
A small percentage of those claims came from abusers, Campana said, so the database should save money by causing a drop in the number of claims.
Here's how the database works: A pharmacist, as required by the new law, would enter the provider's name, the type of prescription and the patient's name in the database. The pharmacy does not have to check the system before handing over the prescription. Providers aren't required to check it before writing a script, either.
But, supporters say, the database will really help in situations where either providers or pharmacists suspect a problem -- maybe a patient "shopping" with four providers in two weeks and showing up to fill a bunch of prescriptions.
Pharmacists can refuse to fill any prescription for any reason, said David Zuck, co-owner of Susitna Professional Pharmacy with Mundell.
"We have not only a legal authority but the responsibility to say no if we suspect something is not right."
With questions about privacy, some critics wonder how the state expects to administer a drug-tracking program when officials struggle on a smaller scale now to track Medicaid prescriptions.
Anchorage naturopath Cary Jasper said he gets letters from the state notifying him of potentially "inappropriate" prescriptions that look excessive or otherwise odd. He calls the pharmacy, they shuffle through records, and find out he wasn't the provider who wrote the prescription.
"When they expand it it's going to be a much bigger mess," Jasper said. "If somebody is in truly great pain, which is a medical emergency, and somebody is denied medication, it's going to be a disaster."
Campana acknowledges that Jasper's concerns are justified.
Before federal regulations changed in May, an estimated 250,000 of the 1 million prescriptions filed for Medicaid beneficiaries came from pharmacies without specific information about who wrote the prescription, he said.
About 25,000 scripts came to the state with the wrong identification code for the provider who wrote them, Campana said.
Since May, the state has required more prescriber information, and hopes new software will help resolve problems with incorrect numbers, he said. "There's a fix that should improve that."
CATCHING THE ROGUES
Alaska is one of 38 states with laws enacting prescription-monitoring programs, with 32 state programs up and running.
Nationally, have the programs made a dent in prescription drug trafficking?
"It's still pretty widespread. It's just easier to track," said Garrison Courtney, a federal Drug Enforcement Administration spokesman. "Once it leaves a doctor and pharmacist's hands, it's anybody's game. ... This at least will help us narrow down if it's a rogue doctor, pharmacist or patient."
State officials and law enforcement authorities say that alone would be a big help. Howes spent six months investigating one prescription abuse case involving 35 different patients because he had to track down all the providers and pharmacies involved.
"It's frustrating from our standpoint," he said. "We can get an allegation of abuse but have to pull in all sources. ... It can be a long and convoluted process for us."
By ZAZ HOLLANDER
Published: February 22nd, 2009 08:24 PM
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