Tight budgets prevent effective use of drug-tracking database

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Though California's prescription-tracking database has survived the state's severe budget cuts, state officials say they don't have the resources to use it effectively, according to the Los Angeles Times.

The Medical Board of California, which licenses and oversees physicians, does not use the system, known as CURES, to flag doctors with questionable prescribing habits. And while state Attorney General Kamala Harris wants to improve CURES to root out drug-seeking patients and to pursue dealers, the Times says Harris has not proposed using CURES as a means to curb over-prescribing.

A spokesman in Harris's office said that even if the system did flag questionable doctors, the state's Department of Justice lacks resources to follow up on leads, according to an Associated Press summary of the Times article.

CURES data is not available to the public; however, the medical board has appealed to citizens to report what they consider irresponsible prescribing after previous Times articles were published on overdose deaths.

Of the top 10 doctors prescribing narcotic painkillers in the Los Angeles area for June 2008, which the Times found through a commercial database used by drug companies, six ultimately were convicted of drug dealing or other crimes, or were sanctioned by medical regulators. Their prescribing was linked to at least 20 deaths, the newspaper reported.

The story says California is not among the states following federal guidelines on tracking irresponsible prescribing. Funds for the database were running low last summer when, California Watch reported, Harris's office was working with healthcare agencies, grant funders and federal authorities to find stable funding for the project. According to the article, the project was down to a small part-time staff as the state Justice Department absorbed $70 million in budget cuts over the past two years.

At least 41 states have enacted legislation to create prescription-tracking databases, with pain doctors pushing for national standards to prevent drug-seeking patients from merely crossing state lines to get their next prescription. Funding remains a problem in many states as well as doctors who don't participate. Many doctors simply don't properly follow up with patients for whom they have prescribed painkillers, a study by non-profit Workers Compensation Research Institute concluded.

New York's I-STOP (Internet System for Tracking Over-Prescribing) legislation has been among the most high-profile efforts to curb prescription trafficking. It requires physicians within three years to begin e-prescribing and to look up patients' medical history beforehand.

To learn more:
- read the Los Angeles Times story
- here's the AP summary
- check out the California Watch article

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