Not Our Problem

Gabapentin (Neurontin) is a drug that is used for nerve pain and as an anti-convulsant. Some people have been using it for years and had no idea that if one took way too much of the stuff that some people would consider the “high” to be a desirable state of mind. The person that I know takes it to moderate headaches caused by spinal stenosis in the cervical vertebrae. A responsible consumer of

drugs, she found that when she took the prescribed dosage that she didn't like the feeling and so cut back to half dosage. Last year the DEA people (who are guardians of anything that might make people high) discovered that some junkies were using it for that purpose and so they listed it as a schedule 4 drug making testing necessary and checking it through KASPER a requirement.

I use a different schedule 4 drug that also became listed several years ago when legislators decided that it also needed to be tested and submitted to KASPER. This adds the cost of quarterly tests to the cost of insurance and drives the cost up to the consumer.

A few years ago when the Opiate Epidemic began to blossom legislators decided that something had to be done about it so they responded in the only way they know how which is to pass a law. Or laws making the possession on uncontrolled amounts illegal which had absolutely no effect on the junkie's

use of them. What it did do is exponentially increase police activity and overcrowd our jails dumping these people into a justice system that had absolutely no idea what to do with them so they either slapped their hands and told them to just stop it or, alternatively, send them up to the Big House so the taxpayer could take care of them more efficiently. Maybe create a few jobs in the process.

Now, it strains credulity to think that the manufacturers of these drugs and the distributors would not be given cause to wonder who in the world is taking all of these drugs since they were flying out of pill mills faster than corn flakes off the grocery shelves. However, every one of them sincerely asserts that they had no idea that those drugs were finding their way into the illegal market.

KASPER was created in 2005 to monitor the supplying and prescribing of scheduled drugs. It was the first such system in the United States and has been a model for other states. The Kentucky All Schedule Prescription Electronic Reporting System (KASPER) tracks controlled substance prescriptions dispensed within the state. A KASPER report shows all scheduled prescriptions for an individual over a specified time period, the prescriber and the dispenser.

Given this system one could assume that over prescribing of drugs would be immediately observable and enforcement actions would be swift but for some reason that seems to not be the case. I don't know why. Since all prescriptions for scheduled drugs has to be submitted to KASPER then why in the world is anything else necessary? But, yet the legislature of Kentucky has seen fit to place further restrictions on reporting these drugs by mandating at least quarterly blood testing to determine whether or not the prescribed drugs are being consumed properly or to investigate whether or not a person is illegally selling their drugs or maybe even using other drugs. Mainly the latter since the state of Kentucky really doesn't care if you're using them properly, only if you're using them improperly.

Doctors now have the DEA and other drug cops who are interested in preserving their jobs peering over their shoulders to make sure they are doing their jobs right. Doctors are scared to death of the liability and some have stopped prescribing such drugs at all. So, here comes the testing. I only have a few cases that I am directly familiar with but anecdotal evidence suggests it is far more prevalent for people to run into the same problems that I have. One has to wait until near the renewal date to go into the doctor's office for testing. Sometimes its a urine test, sometimes a mouth swab. I have to do the mouth swab because I take so little of the drug that laboratories do not test for quantities that small. If the test comes back negative, which sometimes it does, then uh oh. You're at the end of your supply and still don't have a renewal prescription. One time I spent 2 weeks off these meds arguing with my pharmacy that the doctor had submitted a renewal and the pharmacy insisting the doctor had not. One time I stood in the doctor's office and watched the renewal done and the pharmacy still insisted it had not been done. I must admit that the combination of being off my meds and facing such frustration caused me to go ballistic and make a fool out of myself right in the middle of the waiting line. Two weeks is what it took and the pharmacy refused to replace the meds for the time I had missed. Now, if you have been through this for a while you probably have managed to rathole a few just in case of things like this which I had and I had maintained half doses for a while and I wanted to replenish this safety buffer. No way!! My friend is facing the same thing and is experiencing pain and anxiety while waiting for a retest. Was the failure of the lab my friend's fault? Absolutely not but who bears the burden? Why, you bear part of it because we all pay into Medicare. My friend will bear the co-pay. The doctor and the lab will get to bill another visit and repeat. How does that make sense? When my friend asked what she should do while off her meds waiting for the retest what do you think the response was? “Not our problem.” Verbatim.

My Take is that if you are a hammer everything looks like a nail. Legislators who have absolutely no idea what to do with medical procedures inflict laws that have no effect on those who are acting

illegally but have a profound effect on those who are acting legally. Why, in the name of heaven, is submitting the prescriptions to KASPER not sufficient? Illegality could be caught quickly and millions of dollars in policing and testing could be saved. But legislators have to do something to show the voters come election season. This is way easier than trying to formulate a budget.