A Massachusetts "pain management" doctor has lost his license to practice after six of his patients died of causes that may be connected with the addictive painkillers he prescribed. We've read news reports of several such cases in the past year: 71 doctors nationwide were arrested last year and 412 physicians lost the right to prescribe narcotics. Although many people rely on narcotics to handle legitimate chronic pain, illicit prescription drug use has reached epidemic proportions and often requires medically supervised drug detox and drug rehab to resolve.



Doctor shopping – going from one doctor to another faking symptoms to get a prescription – is a major contributing factor to the prescription drug abuse problem. But doctors and pharmacists are sometimes at a loss to determine whether a request for a prescription is legitimate or merely a ploy to get drugs.

Massachusetts Representative Peter Koutoujian says doctors, pharmacists and the medical board could detect potential prescription drug abuse more quickly if they had access to the Department of Public Health's narcotics prescription database, which tracks all such prescriptions. Abusers and addicts could be identified through the database and encouraged to get into drug detox and rehab to handle their drug problem. The database would also allow authorities to identify doctors suspected of over-prescribing and initiate investigations.

However, due to privacy concerns, the database is not available in all states. According to a recent federal survey, only nine states provide physician and pharmacist access to their prescription drug databases. Rep. Koutoujian, who headed a legislative commission on OxyContin abuse last year, said his commission recommended expanding access to the Massachusetts database but, so far, the Public Health Council has refused to change the rules. Says Koutoujian: "We're falling behind the curve" by not doing so.

And the list of Americans needing drug detox or rehab, already at about 21 million, is being extended.

The story of the Massachusetts pain management doctor began back in 1999 when a local pharmacist noticed an unusually high number of patients, sometimes a half-dozen a day, filling prescriptions for high doses of narcotic painkillers all prescribed by the same doctor. Obviously worried about prescription drug addiction, the pharmacist says he stopped filling the doctor's prescriptions in 2002. He also alerted other local pharmacists to the situation. Having no access to the state's prescription database, he set up a special phone line for other area drugstores to call so they could track the prescription requests from that doctor's patients.

A Boston detective was called in and, posing as a patient with back pain, visited the doctor. He received prescriptions for narcotics on nine separate visits. By 2005, at least one complaint about the doctor had been received by regulators and, early in 2006, two health insurers suspended him from their provider networks. But there was still no official investigation. The doctor continued prescribing, and more people were joining the ranks of those needing drug detox for prescription drug addiction and abuse.

It wasn't until May of this year that federal, state, and local law enforcement officials finally acted, soon followed by suspension of the doctor's medical license. But, by then, the doctor was the ninth highest prescriber in the state for the most addictive narcotics, with only hospitals and large institutions prescribing more. His office wrote nearly 12,000 pain-pill prescriptions in 2006 – about six prescriptions every working hour – which adds up to a lot of people abusing and possibly addicted to prescription drugs who should have been in drug detox or rehab instead of filling more prescriptions.

Access to the state's prescription database might have helped prevent the loss of life and unknown numbers of addictions but for concerns about patient privacy. Who would see this private data? Basically it would be the doctor, who already has the patient's file, and the pharmacist, who is already looking at the prescription. At the risk of over-simplifying, what’s the problem, if it gets people into drug detox and rehab and saves lives?

Instead, six people in Massachusetts have died, and dozens or even hundreds more are hooked on narcotic painkillers, people whose lives – if they live through their addictions – may now be ruined unless they get through a proper medical drug detox program and drug rehab.