Online drug monitoring targets 'doctor shoppers'

Danville family helps get pilot program off the ground

A new program unveiled Tuesday by California Attorney General Jerry Brown will provide doctors, pharmacists and police with a new weapon to slow down the rising tide of prescription drug abuse in the state. And Danville resident Bob Pack is largely responsible.

Brown unveiled the Controlled Substance Utilization Review and Evaluation System (CURES) in Los Angeles on Tuesday. The program, one of a handful in the United States, will provide a massive online database of a patient's prescription history that will be available in real time.

The database gives health professionals and others instant access to patient's controlled substance records, replacing the state's previous system, which required faxing information requests. Rather than spend a week or more waiting for the information, officials will be able to find out almost instantaneously. Each year, more than 60,000 requests are made to the Attorney General's office.

Pack knows firsthand the effect that prescription drug abuse can have. In October 2003, Pack's son Troy, 10, and daughter Alana, 8, were struck and killed while walking along Camino Tassajara. The driver of the vehicle, Jimena Barreto, was found to have been drinking and taking Vicodin.

"This started me down the path of how did she get these pills?" Pack said. "I started looking into it and what I found was that in most cases the doctors don't share records. So they're not sharing a patient record even within the same hospital."

Barreto was found to have received multiple prescriptions over the course of several days. Pack said it was this lack of communication among the doctors that led him to begin looking at what would eventually be the CURES program.

"One of the things I thought was, 'Why can't these drugs be tracked electronically and this information shared with doctors and pharmacists prior to prescribing or filling a prescription?'" Pack said. "With this data at their fingertips it might keep them from getting the drugs."

Pack said initially he was uncertain about getting involved with the project, but it was something he felt strongly about pursuing.

"In some ways I certainly did not want to feel like an interloper into the State of California and the Department of Justice but on the other hand it was the memory of my children that was why I was involved. And that just means so much to me."

Four years ago, Pack approached former State Sen. Tom Torlakson and discussed the idea of creating a software system that could run over the Internet to provide a secure way for doctors and pharmacists to log in and check a patient's history.

In 2005, Torlakson created Senate Bill 734, which was the basis for the creation of CURES. It was signed into law in January 2006, but senators asked for more feasibility studies into the privacy of the system and its security.

The Pack Foundation spent $15,000 on the report, which was completed in July 2007. An announcement was made by the Attorney General's office last year that the program was getting under way, which led to Tuesday's unveiling of CURES.

"We got the team, the technical people at the Department of Justice and we held meetings about the system," Pack explained. "I brought in some very good Silicon Valley engineers to kind of guide the work."

The system will be housed at the Department of Justice. Pack said they have protected the information behind both firewalls and electronic countermeasures to make sure all patient information is kept confidential. Funding for CURES comes from Department of Justice, Federal Grant programs and the Pack Foundation.

Federal statistics show that nearly 7 million Americans abuse prescription drugs, more than the number who abuse cocaine, heroin, hallucinogens Ecstasy and inhalants combined. Those figures show an 80 percent increase since 2000.

Following Tuesday's press conference, Pack said he was pleased that the system has gone live.

"It's great," he said, "a feeling of great accomplishment for all the people who've supported this over the years."

With the CURES system live, Pack said he will continue to work with them, improving the system and the speed with which pharmacies are able to enter information into the system.

Currently, once pharmacists fill a prescription, they have seven days to fax in the information, which is then entered into the database. The next iteration of CURES, said Pack, will be an electronic component that will put prescriptions directly into the database increasing real-time access.

Pack said that at the press conference much mention was made of high profile celebrity deaths like Michael Jackson and Heath Ledger that were related to prescription drugs. The question was asked whether the CURES system could have saved their lives.

"The answer is, we don't know," said Pack. "I think it's going to be valuable and save a lot of unknown lives - people who won't be able to abuse prescription drugs anymore."


 +   Like this comment
Posted by Farmer Dave
a resident of Danville
on Sep 18, 2009 at 9:46 am

Farmer Dave is a registered user.

I'm concerned that the CURES may be worse than the disease. Now we will have a state database of exactly what medications all our residents are using. It will do nothing to deter the use of illegal drugs, even though those statistics were confusingly added to the article.

Much was made of the technical safeguards to privacy, but the database will be accessed by humans. We know from "scoops" on celebrity hospital records how secure that can be.

George Orwell's prediction was only 15 years premature.

 +   Like this comment
Posted by Jerold Kaplan, M.D.
a resident of Alamo
on Sep 18, 2009 at 10:19 am

As a physician, I laud CURES. Pain is a great disabler, and should and can be controlled, but unfortunately, a significant number of individuals are addicted or illegally diverting drugs. There is currently no easy way for a physician to know what other prescriptions a patient has obtained, and on several occassions I have been called by pharmacists who have discovered multiple prescriptions obtained by "doctor shopping". The data base, I hope, will not be open to everyone, so that the small possible loss of privacy will be more than offset by an addition to public safety.

 +   Like this comment
Posted by Farmer Dave
a resident of Danville
on Sep 18, 2009 at 12:07 pm

Farmer Dave is a registered user.

Dr. Kaplan,

I see your point, but EVERYONE'S loss of privacy isn't worth the trade-off to protect those few individuals who choose to abuse their bodies. They can still buy drugs illegally.

 +   Like this comment
Posted by Jeff Leston
a resident of another community
on Sep 19, 2009 at 7:01 am

Intersting, but CURES is locking the barn door after the cows have left. Docotr shoppers hit a number of physicians in short order, and by the time it gets into the database it's too late.

If they really want to stop doctor shopping, emial me at

 +   Like this comment
Posted by Ralph Hoffmann
a resident of Walnut Creek
on Sep 23, 2009 at 8:01 am

There's a ribbon cutting scheduled for the C3 Collective (Medical Marajuana Dispensary), on Thu. October 8, at 5:30pm 1291 Oakland Blvd., Walnut Creek.

 +   Like this comment
Posted by Davide
a resident of Charlotte Wood Middle School
on Oct 3, 2009 at 10:07 am

needed here

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