Media plays key role in changing Calif.’s prescription drug tracking law

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October 17, 2016

Bob Pack proves the old adage that persistence beats resistance.

Ever since he lost his two children in an accident involving a driver high on prescription pain pills, he has pushed for better monitoring of prescriptions.

I have written about his efforts repeatedly. He had a partial victory in 2009 when California Gov. Jerry Brown announced a plan — devised by Pack — to fix flaws in California’s Controlled Substance Utilization, Review and Evaluation System (CURES). CURES has never lived up to its promise. It’s supposed to allow licensed health care prescribers, pharmacists, law enforcement officials and regulatory boards to track who is prescribing drugs and who is receiving the prescriptions. But it has not been used to its full potential. As Pack explained to me previously:

To my astonishment, the system seemed archaic. Doctors were required to fill out a patient inquiry form and fax it into the state Department of Justice, where someone would then manually look up that patient's prescription history in the database and then fax back the requested information. This would often take anywhere from weeks to well over a month. By then, the patient already had taken the prescription and filled it at the pharmacy.

Brown’s pledge in 2009 did not amount to much more than a good speech. Pack’s plans were not implemented in any meaningful way. Then in 2013, Pack persuaded a state senator to propose new spending by the state that would actually make some of the changes that were promised by Brown. In order to get the law passed, state legislators had to cut deals with the state’s physician lobby that ultimately made the legislation much weaker. But it did make some changes: In January 2014, all doctors who prescribed addictive drugs were required to register with CURES and required to pay a $6 annual fee to help fund the system. Pharmacists were required to enter all prescription drug orders into the CURES database, and also required pay a $6 fee.

But here’s the rub: an effort to require drugmakers to provide funding for the program failed, leaving monitoring and enforcement underfunded. And the 2013 law does not require all physicians to actually check the CURES database before writing a new prescription for an addictive drug.

Pack did not give up.

He worked to get an initiative on the ballot in California that would have, among other things, better funded the CURES program, required doctors to check it, lifted the state’s malpractice payment cap, and required doctors to submit to random drug testing. The initiative failed in November 2014.

But, again, Pack did not give up.

Finally, his efforts paid off with California Senate Bill 482, which was recently signed into law by Gov. Jerry Brown after passing the Assembly 80-0 and the Senate 39-1. It requires doctors to check the state’s CURES database before prescribing narcotics.

Why, after so many years of prescription drug laws failing to gain traction, did the state change its tune? Pack told me that he thinks the increasing media attention on prescription drugs has made a big difference over the last few years:

When I first started 10 years ago, there was little attention and legislators aligned them-selves with special interests in the medical and pharmaceutical industries. The problem is so pervasive now that every day there are editorials about prescription drug deaths and abuse.

He’s right. Health reporters were early to pick up on prescription drug abuse problems in their communities. And state legislators — and now presidential candidates — have followed with programs, policies, and penalties to try to prevent more tragedies like the loss of Troy and Alana Pack. 

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