Doctors want to improve state drug-tracking system

Doctors in Indiana overwhelmingly prescribe controlled substances for pain and other symptoms but infrequently use an electronic system designed to detect prescription drug abuse, a study released Monday found.

The findings presented to the state Board of Pharmacy by Indiana University's Center for Health Policy show that nearly 90 percent of Indiana's doctors and dentists said they had prescribed controlled substances within the past year. And while most doctors said they used the INSPECT drug tracking system, only about 20 percent said they had used it within the past month.

Many said they simply didn't have time to check the system every day.

While most doctors and some dentists said they had heard of INSPECT, only 12.7 percent use it on a daily basis, said Dr. Eric Wright, a Georgia State University professor who formerly was with the Center for Health Policy. However, one reason may be that they have to wait seven days for the results. A substantial number of doctors said they wish the system would let them know instantly whether a patient is obtaining the same prescriptions from multiple sources.

Most of the 6,000 doctors, dentists, pharmacists and others who replied to the survey said they were aware of the system and the problems with it, but said they wanted to know more. And while many saw room for improvement, they didn't always agree on how to improve the system.

"Everyone recognizes the problem, but there's no consensus on what the guidelines should be," Wright told the board.

Since 2004, the system has allowed doctors and pharmacists to determine whether patients are obtaining multiple prescriptions of powerful painkillers and other drugs that are often abused. Prescription drugs were blamed for 718 overdose deaths in Indiana in 2011, a nearly 10-percent increase from 2010's 654 deaths.

Doctors said they prescribed controlled substances to about 20 percent of their patients to help them manage chronic pain, Wright said.

"Hydrocodone is extremely popular," said Master Indiana State Trooper Tamara Watson, who was sitting in the audience during the study presentation. "It's popular because it's overprescribed."

Watson is a former undercover drug officer and a member of the attorney general's "Bitter Pill" task force against prescription drug abuse. She said it's difficult for physicians to determine when patients are faking certain symptoms such as pain or depression for which controlled substances are often prescribed.

Wright said many physicians were concerned about their patients' privacy and wished police would be required to get a court warrant before delving into the system. Many had similar concerns about state-centralized control, such as a requirement that they use the system to check on every patient.

"They were very concerned about trying to run a private practice from the Statehouse," Wright said.