Coventry changes course, will pay for addiction-treatment drug

Reversing its decision, likely after it was pressured to do so, a Medicaid managed-care organization will continue to pay for a drug used to treat drug addiction.

Coventry Cares said it "decided to change course after talking to representatives of a chain of addition treatment clinics that threatened last week to sue Coventry," reports Beth Musgrave for the Lexington Herald-Leader.

Last week, the Cabinet for Health and Family Services sent Coventry a letter expressing its displeasure about the MCO's move, saying it would be a contractual violation. The drug in question is Suboxone, an expensive treatment option for addicts dependent on taking opioids such as Oxycontin and Vicodin. Coventry had said it was aligning its coverage in keeping with Medicaid policy, moving to only cover the full price of the drug for pregnant or recently pregnant women and youth under 21.

After the MCO discussed the issue with SelfRefind, the chain of addiction treatment clinics in question, "Coventry understands their concerns," said Coventry spokesman Eyles. "As a result, we will continue covering Suboxone and similar medicines for all Coventry members while we work through the cabinet's process to determine whether these drugs should be covered for certain categories of Medicaid recipients or everyone." (Read more)

Medicaid managed-care firm Coventry plans to stop paying for expensive drug that curtails addiction

Coventry Cares, one of the four firms that manage patient care for the state Medicaid program, has once again hit the headlines, this time for its plans to stop paying for medicine that helps addicts keep their opioid addiction at bay. State officials quickly condemned the move Thursday and called it a contract violation, reports Beth Musgrave of the Lexington Herald-Leader.

Coventry decided to stop paying for buprenorphine, more commonly known as Suboxone, which helps curtain cravings for drugs such as Oxycontin and Vicodin. A 30-day supply of the drug can cost more than $450, Musgrave reports.

"They will be at risk for relapsing and going back to using illegal opioids," Dr. Michelle Lofwall, an addiction specialist and assistant professor at the University of Kentucky, told Musgrave. "Whenever you are using illegal opioids, there is a risk of overdose and death."

Coventry said it will no longer offer the coverage because only pregnant women, women who recently gave birth and those under the age of 21 are eligible for addiction treatment in Kentucky's Medicaid program. "What we've done is align our coverage with the cabinet's Medicaid policy," said Matt Eyles, a Coventry spokesman.

However, the state Cabinet for Health and Family Services said the decision violates the contract and "cannot take this unilateral action without the cabinet's approval," said Jill Midkiff, a cabinet spokeswoman. 

A company that operates addiction treatment centers across the state was planning to file suit over the move Friday, but, after learning of the cabinet's reaction, "We are going to give them the chance to work this out," Anna Whites, an attorney who represents SelfRefind.

Coventry already caused controversy this week when it informed Baptist Health System wants to renegotiate its contract. The move comes just a week after Coventry and Appalachian Regional Healthcare came to a temporary agreement after Coventry threatened to terminate its contract and ARH sued Coventry. The company has also told King's Daughters Medical Center in Ashland it will terminate its contract after May 26. (Read more)

Meds-for-meth bill drew record lobbying expenses, not even including radio and newspaper ad campaigns

Makers of over-the-counter drugs spent more than any lobbying interest ever had during a single Kentucky legislative session in their effort to defeat a bill requiring prescriptions for the key ingredient in methamphetamine, Bill Estep reports for the Lexington Herald-Leader.

"The Consumer Healthcare Products Association spent $457,053 on lobbying activities in the first three months of this year's legislative session, according to reports filed with the state Legislative Ethics Commission," Estep writes. "The group's lobbying effort was so dominant that it spent more than the next five groups combined in that period, January through March, according to spending reports."

And the figure doesn't even included hundreds of thousands of dollars that the trade group spent on radio and newspaper campaigns, because the lobby-reporting requirements do not apply to messages aimed only at the general public. The group did report spending on "a phone-bank operation to put people in contact with legislators to voice concerns about legislation to require a prescription for medicine containing pseudoephedrine, which is now available over the counter," Estep writes.

Read more here: http://www.kentucky.com/2012/04/30/2170495/makers-of-cold-medicines-set-new.html#storylink=cpy

The efforts, dating back to 2010, were partly successful. The legislature passed a bill "that will require a doctor's prescription for pseudoephedrine, but only after someone has bought 24 grams of the medicine a year," Estep notes. "A 48-count box of the generic medicine with 30-milligram pills contains 1.44 grams of pseudoephedrine. The bill excludes limits on gel caps and liquid pseudoephedrine." (Read more)

The lobbying effort wasn't only about Kentucky. The makers of Sudafed and other pseudoephedrine preparations are trying to stave off similar efforts in other states, and viewed Kentucky as a sort of firewall after seeing prescription-only laws pass in Oregon and Mississippi.

Read more here: http://www.kentucky.com/2012/04/30/2170495/makers-of-cold-medicines-set-new.html#storylink=cpy

Read more here: http://www.kentucky.com/2012/04/30/2170495/makers-of-cold-medicines-set-new.html#storylink=cpy

1 in 4 grandparents keep meds where kids can reach them

A new poll shows nearly one in four grandparents say they store prescription medicines in places that can be accessed by children. Unintentional poisonings cause more visits to the emergency room for young children — one every 10 minutes — than car accidents, to say nothing of the threat of theft, a factor in the prescription-drug epidemic that is killing more Kentuckians than such accidents.

The most common type of prescriptions that are accidentally ingested are opioids, the poll found. The most common type of over-the-counter medicine ingested is acetaminophen, the active ingredient in Tylenol, reports research-reporting service Newswise.

The poll found that 23 percent of grandparents and 5 percent of parents store prescription meds in easy-to-access places. Eighteen percent of grandparents and 8 percent of parents said they store over-the-counter medicine in easily accessible spots.

"Emergency room visits for accidental poisonings among young children have become much more frequent in the last decade," said Matthew Davis, director of the C.S. Mott Children's Hospital National Poll on Children's Health. "We hope the results of this poll are a reminder to parents, grandparents and all those who care for young children: check around your homes to make sure that medicines are safely stored out of reach." (Read more)

Though the numbers are on the rise, on the whole, American children are safer than they ever were, according to the Centers for Disease Control and Prevention. The rate of death from unintentional injuries dropped 29 percent from 2000 to 2009. Deaths dropped from 12,400 in 2000 to about 9,100 in 2009.

Poisoning death rates rose dramatically, however‚ going up 91 percent in youths aged 15 to 19, "a byproduct of the rising prescription-drug abuse among teens who either obtain the pills illegally or swipe them from medicine cabinets of their parents or others," reports Timothy Martin for The Wall Street Journal. (Read more)

Pain-pill problem has spread to new areas from Appalachia

Sales of hydrocodone (the key ingredient of Vicodin, Norco and Lortab) and oxycodone (the main ingredient in OxyContin, Percocet and Percodan) skyrocketed in new parts of the country as the problem spread from its Appalachian roots in the last decade, an Associated Press analysis shows.

Oxycodone sales in Tennessee, New York and Florida were up by more than 499 percent from 2000 to 2010, the highest increases in the country, the study shows. When it came to hydrocodone, South Dakota had the highest increase, with 300 to 399 percent.

In Kentucky, oxycodone sales increased by 171 percent and hydrocodone sales increased 176 percent from 2000 to 2010. Kentucky's increase was not as high because the problem started in the eastern part of the state and in West Virginia, with coal miners needing relief from back and chronic pain, reports the AP's Chris Hawley. The problem also started in affluent suburbs, said Pete Jackson, president of Advocates for the Reform of Prescription Opioids. "Now it's spreading from those two poles," he said.

In 2010, pharmacies dispensed 69 tons of oxycodone and 42 tons of hydrocodone nationwide. "That's enough to give 40 5-milligram Percocets and 24 5-milligram Vicodins to every person in the country," Hawley reports.

As sales increase, so do overdose deaths and pharmacy robberies, Hawley reports. Opioid pain relievers, a category that includes oxycodone and hydrocodone, caused 14,800 overdose deaths in 2008 and numbers are rising, according to the Centers for Disease Control and Prevention.

Part of the increase in sales can be blamed on the fact that the U.S. population is aging, resulting in more pain issues. There is also more of a willingness by doctors to treat pain, said Gregory Bunt, medical director at New York's Daytop Village chain of drug treatment clinics. But they're also increasing because people are addicted. "We all recognized that these drugs can be just as dangerous and deadly as illicit substances when misused or abused," said Gil Kerlikowske, the U.S. drug czar.

The AP analysis used drug data collected four times a year by the Drug Enforcement Adminstration's Automation of Reports and Consolidated Orders System. "The DEA tracks shipments sent from distributors to pharmacies, hospitals, practitioners and teaching institutions and then compiles the data using three-digit ZIP codes," Hawley writes. "Every ZIP code starting with 100-, for example, is lumped together into one figure."

ZIP codes that include military bases or Veterans Affairs hospitals have had large increases because of treatment of injured soldiers. Some areas are affected because mail-order pharmacies have shipping centers there. Areas with large Indian reservations also had larger numbers.

The most sweeping trend, though, is how the pain pill epidemic has spread to areas previously untouched. In 2000, Florida's oxycodone sales were centered around West Palm Beach. By 2010, they were common in almost every part of the state. It has become commonplace in New York City and its suburbs. Staten Island alone saw a sales jump of 1,200 percent. And Tennessee had a five- to six-fold increase in that decade. "We've got a problem. We've got to get a handle on it," said Tommy Farmer, a counterdrug official with the Tennessee Bureau of Investigation. (Read more)

For a view of an interactive map that shows more Kentucky numbers, click here.

Legislature passes bill on personal-care homes but stalls on one to regulate pill mills as doctors lobby hard

By Al Cross
Kentucky Health News

The effort to quash "pill mills" that feed one of Kentucky's worst problems, prescription drug abuse, stalled on the next-to-last day of the General Assembly's session and faces cloudy prospects on April 12, when the legislature returns to conclude its business. But the legislature gave final passage to a bill aimed at limiting the admission of mental patients to personal-care homes.

The snag in the pill-mill bill stems from the Kentucky Medical Association's opposition to moving the state's electronic prescription-tracking system to the attorney general's office from the Kentucky Board of Medical Licensure, which is controlled by doctors and has been found to go easy on them, compared to other states. The bill includes several other measures, including a requirement that pain clinics must be owned by doctors.

After Sen. Carroll Gibson, R-Leitchfield, failed in a parliamentary maneuver to make the bill more difficult to pass, and Senate President Pro Tem Katie Stine, R-Southgate, ruled that his motion had lost on a voice vote, Majority Floor Leader Robert Stivers, R-Manchester, "said it might be better to consider the bill April 12, but Sen. Ray Jones, D-Pikeville, said delaying a vote on it would give its opponents more time to try to kill it," report John Cheves and Jack Brammer of the Lexington Herald-Leader. "Stivers called for party caucuses to meet to discuss the issue. After the caucus meetings, the Senate adjourned and Stivers said lawmakers would work on the bill for possible consideration April 12."

The session's final day is scheduled to give the legislature a chance to override any vetoes by Gov. Steve Beshear, so a bill passed then could be killed by a veto. That might seem unlikely, since Beshear has been among those pushing for stronger action against pill mills. However, if he were unhappy with a bill the legislature sent him, he could veto it and call a special legislative session to pass one more to his liking. That possibility, and his power to set the agenda of a special session, could make him a player in the negotiations between now and April 12.

The bill’s sponsor, House Speaker Greg Stumbo, D-Prestonsburg, downplayed the problem. He blamed it on "confusion over a provision that limits the amount of drugs that may be supplied to a patient at any one time," Mike Wynn of The Courier-Journal reports. "Some lawmakers feared that limits on prescriptions would cause more patient co-pays, but a simple fix to the bill’s language could allay those concerns, Stumbo said."

Also on Friday, the legislature sent Beshear a bill that would "require potential residents at personal-care homes to be screened for brain injuries by medical professionals," the Herald-Leader reports. "Personal care homes provide long-term care for people who do not need full-time nursing care but need some assistance."

Senate Bill 115 "stems from the death last year of Larry Lee, a brain-injured resident who disappeared from a personal care home and was found dead four weeks later on the banks of the Licking River, not far from the Falmouth Nursing Home in Pendleton County," the Herald-Leader notes. "There are about 2,500 to 3,000 people in 82 free-standing personal care homes across Kentucky," and many are mentally disabled or mentally ill. Kentucky Protection and Advocacy, a watchdog state agency, released a report last week saying that said placement of the mentally ill in personal-care homes violates federal disability laws. (Read more)

Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

'Meds for meth' bill is about to become law despite heavy lobbying campaign by pharmaceutical companies

The bill to limit purchases of a popular cold medicine used to make methamphetamine passed the General Assembly today and Gov. Steve Beshear said he would sign it.

The Senate voted 29-8 to approve changes the House made in Senate Bill 3, sponsored by Senate Majority Floor Leader Robert Stivers, R-Manchester, left. The bill would require a prescription to buy more than 7.2 grams of pseudoephedrine in a month and 24 grams in a year. "A generic box of pseudoephedrine with 48 pills, each with a 30-milligram dosage, contains 1.44 grams of the medicine," Jack Brammer of the Lexington Herald-Leader reports. ""Gel caps and liquid pseudoephedrine would be excluded from the limits in SB 3 because making meth from those forms is considered more difficult."

The bill’s sponsors had wanted lower limits, an initially a prescription for any amount, "but they compromised with opponents who worried about inconveniencing cold and allergy sufferers," Brammer notes. "The pharmaceutical industry has lobbied aggressively against the state requiring prescriptions for pseudoephedrine at any level," ranking first in reported lobbying expenses without even counting its extensive advertising campaign. The industry apparently viewed Kentucky as a sort of firewall, the absence of which could make passage of similar "meds for meth" bills in other states. Only Oregon and Mississippi now have such legislation.

Meds-for-meth, pain-pill bills each clear a second chamber; both probably headed to conference committee(s)

"State lawmakers gave new life Wednesday to two bills designed to tackle Kentucky's problems with methamphetamine labs and prescription drug abuse," John Cheves and Jack Brammer report for the Lexington Herald-Leader.

"On a 60-36 vote, the House approved Senate Bill 3, which would further limit the amount of cold medicines containing pseudoephedrine that consumers could buy without a prescription. Pseudoephedrine is a key ingredient used in making meth. Meanwhile, the Senate approved House Bill 4, which transfers from the state Cabinet for Health and Family Services to the attorney general's office an electronic monitoring system that keeps track of prescriptions for pain pills. The vote was 26-9. Both bills are likely to go to conference committees made up of representatives from both chambers, who will try to negotiate a compromise on differences in the House and Senate versions of the bills." (Read more)

Meds-for-meth bill stalls in state House committee

A measure aimed at curbing methamphetamine production failed to come to vote in the House Judiciary Committee Tuesday. Rep. John Tilley, a Hopkinsville Democrat who chairs the committee, said he hopes Senate Bill 3 will be voted on later this week.

The bill, which was passed by the Senate March 2, "would allow consumers to buy 7.2 grams per month of medications containing pseudoephedrine and up to 24 grams annually, an amount adequate for most cold or allergy sufferers, according to testimony," reports Deborah Yetter for The Courier-Journal. "A doctor's prescription would be required for an additional 7.5 grams per month or an additional 90 grams per year." The bill would exempt liquid or gel-cap formulations of the drug.

Right now, Kentuckians can buy 9 grams of the medicines per month and 120 grams per year.

Some committee members said they are concerned people could be breaking the law if they get or own too much of the drug. Rep. Joe Fischer, R-Fort Thomas, said his wife takes Claritin D, which contains pseudoephedrine, for allergies on a regular basis and asked if the bill would make it too hard for people like her to get the drugs without going to the doctor first. (Read more)

Anti-meth bill passes Senate; limits monthly pseudoephedrine purchases to 7.2 grams a month and 24 grams a year

In an effort to curb methamphetamine production, the Senate passed a bill Friday that will limit the amount of pseudoephedrine that can be bought monthly and annually.

Senate Bill 3, approved 25-11, will allow consumers to buy 7.2 grams of medicine containing pseudoephedrine per month and up to 24 grams per year. The bill now goes to the House for consideration. House Speaker Greg Stumbo, D-Prestonsburg, said House members generally support what the bill is trying to accomplish but want to study its details, report Jack Brammer and Beth Musgrave of the Lexington Herald-Leader.

Right now Kentuckians are allowed to buy 9 grams per month and 120 grams per year. Sen. Robert Stivers, R-Manchester, sponsored the bill, which originally only allowed the purchase of 3.6 grams per month and 15 grams per year. That changed after Sen. Jerry Rhoads, D-Madisonville, filed an amendment that increased the limit to the 7.2 and 24 grams. (Associated Press photo by the late Ed Reinke of Sen. Stivers)

The bill also prohibits anyone who has been convicted of a drug-related offense from buying the drug for five years. Pseudoephedrine, which is in several cold and allergy medicines, is the key ingredient to make meth. The bill does not pertain to pseudoephedrine that comes in gel or liquid format; meth is more difficult to make using these formulations.

"I still don't think it's the best situation," Stivers said of the revised bill. "It's what we could get passed. Let's see what this does."

Opponents, namely the Consumer Healthcare Products Association, were "disappointed with the outcome of the vote," said Scott Melville CHPA president and chief executive. "CHPA is committed to working with legislators to win the battle against methamphetamine, but gaining the upper hand against meth producers and dealers does not require unnecessary restrictions imposed on many Kentucky families — particularly seasonal allergy sufferers — by burdening them with increased health-care costs, lost wages, and unnecessary trips to the doctor."

The CHPA represents makers of over-the-counter drugs and is continuing a vigorous and expensive campaign of lobbying and radio commercials to defeat the bill. (Read more)

Compromise meds-for-meth bill clears committee; third drug-related bill to pass this week

Update, March 2: Just hours after the committee approved the bill, Senate Majority Leader Robert Stivers, R-Manchester, "declared its future uncertain," reports Jack Brammer for the Lexington Herald-Leader. Stivers said there is "a very successful lobbying campaign" against Senate Bill 3 and said he did not "want to subject lawmakers to continued pressure by the makers of pseudoephedrine," Brammer reports. Though he wouldn't call the bill dead for this year, Stivers said he would decide soon on whether he would continue to pursue the bill's future. (Read more)

The compromise bill that will require a prescription to buy pseudoephedrine after a monthly or annual limit is reached passed 7-4 in the Senate Judiciary Committee this afternoon.

Senate Bill 3 will allow people to buy up to 3.6 grams of the drug a month and a maximum of 15 grams per year. After those limits have been reached, patients will have to see a doctor to obtain a prescription for more. The intent of the bill is to curb methamphetamine production — pseudoephedrine is the key ingredient to make the drug.

Now, people are limited to buying 9 grams per month and 120 grams per year.

Today, the committee approved an amendment to the bill, which will allow patients to buy 7.5 grams per month if a doctor says that amount if required, which amounts to 90 grams a year under these special circumstances.

The bill also prevents anyone who has been convicted of any drug-related crime — whether the crime was related to meth or not — from buying pseudoephedrine without a prescription for five years.

Sen. Robert Stivers, R-Manchester, made an impassioned argument for the bill, which he introduced earlier this week. He said the compromise works because "any box you look on will tell you that you should take this for no more than 14 consecutive days without seeing a doctor." The 3.6-gram monthly allotment will allow for 14 days' use.

As for the criticism that the reduction won't be enough to cover whole families who may be suffering from allergies or cold, Stivers argued "anyone who is subjecting a child to this continuous use on a repetitive basis is not really taking care of the child or the symptoms that cause their problems."

Carlos Gutiérrez of the Consumer Healthcare Products Association, which represents makers of over-the-counter medicine, said it is "adamantly against" the compromise bill, saying "we feel very strongly about the rights of consumers to buy a legal product." He pointed out if a chronic allergy sufferer takes 1 pill a day, that adds up to 7.2 grams per month.

Sen. Tom Jensen, R-London, questioned Guetiérrez and had him confirm that 84 percent of people who buy pseudoephedrine use less than 15 grams of the medicine per month, according to 2010 figures. He further established that the remaining 16 percent of people are buying 60 percent of all the pseudoephedrine sold in Kentucky.

House Judiciary Committee approves two bills to curb synthetic, Rx drug abuse

Cracking down on drugs is one of the most pressing topics of the 2012 General Assembly, and lawmakers showed they were serious about it this afternoon. (Associated Press photo by Ed Reinke of House Judiciary Committee Chairman Rep. John Tilley, D-Hopkinsville)

In an effort to get a handle on prescription drug abuse — and so-called pill mills that supply the addictive medications — the House Judiciary Committee approved a bill that will place controls on pain management clinics, reports Jack Brammer of the Lexington Herald-Leader. House Bill 4 also puts the power to police the problem into the hands of the attorney general; cracks down on prescribers who have had trouble with the law for drug-related crime; requires that the clinics be owned by people who have a medical background; and will get a detailed look at how many deaths are occurring by having coroners report any death caused from the use of drugs or drug overdoses.

"We don't really know how bad (the problem) is," said House Speaker Greg Stumbo, the Prestonsburg Democrat who filed the bill. "I think it will astound us when we get the results in because I think it might double what we think the numbers are."

The committee also approved House Bill 482, which prohibits trafficking and possession of synthetic drugs that are sold as bath salts or incense in convenience stores and other places. The measure, sponsored by committee chairman John Tilley, D-Hopkinsville, was passed unanimously.

Both bills will now go to the full House for consideration. (Read more)

Meds-for-meth compromise bill introduced

Lawmakers said they would compromise on the idea of making pseudoephedrine available only by prescription, and they have. Senate Bill 3 would only require a prescription for medicines containing the drug after a patient has bought 3.6 grams of it per month and a maximum of 15 grams per year. Gelcaps and liquid forms of the drug would still be excluded. (Associated Press photo by John Flavell of recovering addict Melanda Adams and Senate Majority Floor Leader Robert Stivers, who introduced the bill)

Now, people are limited to buying 9 grams per month and 120 grams per year of cold and allergy medicines containing pseudoephedrine, which is the key ingredient to make meth. The bill would also prevent anyone who has been convicted of a meth-related crime from buying the drug without a prescription for five years.

Last week, Sen. Robert Stivers, R-Manchester, withdrew a bill that would have required a prescription for any purchases of the drug. Stivers introduced this new bill yesterday and told The Courier-Journal it gives people who use the medicines "adequate opportunity without incurring medical expenses or the cost of a prescription to access these on a monthly basis and an annual basis."

Opponents to the bill still feel it is too restrictive, with the Consumer Healthcare Products Association continuing "to oppose burdensome restrictions to over-the-counter cold and allergy medicines that thousands of law-abiding Kentuckians rely upon for relief," Elizabeth Funderburk, senior director of communications for the group that represents makers of over-the-counter medicine and dietary supplements, told the Louisville newspaper.

Opponent Pat Davis, mother of six and wife of 4th District U.S. Rep. Geoff Davis, railed against the new proposal. "I'm not sure why they're calling it a compromise bill because I'm not sure who they compromised with," she said. She pointed out if four members of her family were to get sick with a cold, and took Sudafed to treat it for seven days, that would amount to 13.44 grams of the medicine — nearly the annual limit. "Really what this bill is is the same bill," she said. "They're throwing out a few crumbs, which they're calling 15 grams."

Jackie Steele, commonwealth's attorney for Laurel and Knox counties, told the paper that the lower limits could lead to a reduction in meth labs, but not for long. "I hope this cures it," he said of the meth-lab problem. "I don't think it will."

In London, whose Walgreens has the highest sales of pseudoephedrine in the state, Police Chief Stewart Walker agreed with Steele. "The bad guy is always going to figure a way around this," he said. "(With the compromise) you probably leave the door partly open and there's so much more room for added work."

The Senate Judiciary Committee could consider the new bill Thursday, and the entire Senate could vote on it this week, Stivers told the Lexington Herald-Leader. (Read more) For The Courier-Journal's story, by Jessie Halladay and Tom Loftus, click here.

Meds-for-meth bill sent back to committee; compromise in the works, original sponsor says

The bill that would make pseudoephedrine — the key ingredient to make methamphetamine — available only by prescription was taken off the Senate floor Thursday afternoon. The bill's original sponsor, Sen. Tom Jensen, R-London, said "he expects a compromise is near," reports Jessie Halladay for The Courier-Journal.

"We've probably reached some consensus on where we want to go," said Jensen, right, but declined to go into details about the compromise. Of a possible concession, he would only say, "It's not necessarily what I want and it's not necessarily what the industry wants," but would be a step in the right direction.

Senate Bill 50, which was narrowly approved by the Judiciary Committee last week, has been opposed by the pharmaceutical industry, which says it imposes an unnecessary burden on users who need the medicine for the relief of colds and allergies. Many law enforcement agencies, including the Kentucky Narcotics Officers Association, support the bill, saying it would made a big dent in the number of meth labs found in the state. The bill excludes pseudoephedrine that is sold gel-cap format. (Read more)

Courier-Journal editorialists change position and join the Herald-Leader in supporting meds-for-meth legislation

The state's two biggest newspapers are in agreement: pseudoephedrine should be available by prescription only in order to curb methamphetamine production. The Courier-Journal offered its opinion in an editorial today: "Meth remains a scourge in Kentucky. It is not going to go away soon and without strong action its deadly, family-shattering impact will not diminish."

The position represents an about-face for the paper in Louisville, where the editorial board previously felt "such a restriction would create unnecessary burdens and expenses for legitimate users of pseudoephedrine."

However, with the meth problem not going away — there were a record 1,080 labs discovered in 2010 — the newspaper has changed its position, though acknowledged prescription-only will create some problems of its own: "'Pill mills' will likely dispense pseudoephedrine, just as they now illegally and unethically flood the market with pain medication, and police will have to crack down on such sales."

In December, the Lexington Herald-Leader offered its position, backing a prescription-only pills bill by Rep. Linda Belcher, D-Shepherdsville. "Methamphetamine would be a scourge if it hurt only those who ingested it. But the harm is far more widespread than that," it reads. "Highly mobile and as compact as a large soft-drink bottle, the meth-making process creates a risk of toxic exposure, respiratory injury and fire to all who come close."

The Courier-Journal backs Senate Bill 50, sponsored by Sen. Tom Jensen, R-London, and Sen. Robert Stivers, R-Manchester, which is similar to Belcher's bill. It narrowly cleared the Senate Judiciary Committee last week, but opposition to it "has hardened" in the Senate, the editorial reads. (Read more)

Columnist likens pain docs to drug pushers and loan sharks

Doctors at some pain management clinics are the equivalent to modern-day drug pushers, writes Richmond business columnist Don McNay in a piece entitled, "Making money in businesses that are supposed to (and should) be illegal."

"People spend a few minutes and lots of money to get a 'physical'," he writes. "They skip insurance and pay the clinic with cash or a credit card. The 'medical staff' will then arrange for you to get a large order of the highly addictive pain medicines prescribed by the clinic doc. You can often get the prescription filled right at the clinic."

McNay points out such clinics are "perfectly legal" in Kentucky and owners do not have to have a medical background. (A bill in the legislature would change that.) "I'm not a lawyer, but would love to own a law firm," he writes. "I'd like to own a plumbing contracting firm but not be a licensed plumber. . . . None of those options are available to me. But owning a pain management clinic is."

He likens the clinics to payday lenders, which he likens to "legalized loan sharking." He also takes issue with the "Super PAC" concept, which allows corporations to make unlimited contributions to political campaigns. "With super PACs allowing corporations to give unlimited amounts to fund campaigns," he writes, "the big corporations control the political process."

McNay concludes, "As a society, it would seem logical that we would want drug pushing, loan sharking and corporate influence peddling to stop. At the very least, we could go back to making it against the law." (Read more)

Group fighting meds-for-meth bill says it spent nearly $200,000 in January on lobbying, and that apparently omits radio buys

The group fighting a bill that would make the key ingredient for making methamphetamine available only by prescription spent more than $194,000 last month alone to lobby lawmakers, far more than any other lobbying interest at the General Assembly.

The Consumer Healthcare Products Association "reported spending more on Frankfort lobbying for the month than the next eight largest groups combined," reports Tom Loftus of The Courier-Journal. "That's almost an obscene amount of money to be spending on one month on one issue," said Senate Majority Leader Robert Stivers, R-Manchester. Stivers is sponsoring the bill, which would require a prescription for cold and allergy medicine that contains pseudoephedrine.

The group with the second highest spending was the Kentucky Hospital Association, at $36,120.

CHPA "is a group of manufacturers and distributors of over-the-counter medicines whose members include Bayer Healthcare, GlaxoSmithKline and Johnson & Johnson," Loftus reports. In a statement Monday, the group said it is again "efforts by some legislators to deny law-abiding citizens nonprescription access to certain cold and allergy medicines they depend on."

The $194,957.76 spent on lobbying apparently does not include what the CHPA spent on broadcast advertising, which it does not have to report. As of Feb. 3, the group had spent more than $82,000 running ads on Louisville, Lexington and Somerset radio stations owned by Clear Channel Communications Inc., the nation's largest radio operator, according to public-inspection files at those stations, the only ones that have been checked by Kentucky Health News and its journalistic partner, Jonah Engle. In 2011, CHPA paid the Kentucky Association of Radio and Television more than $93,000 to run ads, according to public-inspection files from Cumulus Broadcasting, another major owner of stations in Kentucky.

As for lobbying expenses, more than $12,000 was spent on salaries for three lobbyists, plus nearly $4,000 for food, lodging, beverage and transportation expenses. More than $150,000 was spent "for professional and technical research and assistance," plus nearly $27,000 for "educational and promotional items."

"I'm not surprised they reported so much for lobbying because it's obvious they're doing a pretty good job of getting their message out ... which I believe is a misleading scare campaign," said Sen. Ray Jones, D-Pikeville, who is co-sponsoring the meds-for-meth bill. (Read more)

Senate committee narrowly passes meds-for-meth bill as advocates start their own radio advertising campaign

In the face of a strong lobbying effort by makers of over-the-counter cold medicines, a state Senate committee narrowly approved a bill today that would require a prescription for most products containing pseudoephedrine, a key ingredient used to make methamphetamine.

Senate Bill 50, approved 6-5 by the Judiciary Committee, is sponsored by Senate Majority Floor Leader Robert Stivers, R-Manchester, left, but he said he isn't sure of its chances in the full Senate, reports Jack Brammer of the Lexington Herald-Leader. A similar bill got out of committee last year but never came to a vote on the Senate floor because it lacked the votes to pass. This year's bill would not apply to gelcaps, which are more difficult to use in meth making.

The Kentucky State Police recorded about 1,200 meth labs last year, and former meth addict Melanda Adams, from Stivers' home Clay County, told the committee she believed the bill would "cut the burgeoning number of dangerous home-made meth labs in the state." The Consumer Healthcare Products Association, a non-profit that represents the over-the-counter medicine industry, argues that requiring a prescription would "create a hardship for legitimate consumers," reports Jessie Halladay of The Courier-Journal.

Only Oregon and Mississippi have passed such laws, so Kentucky has become a firewall for the drug makers' lobby, which has bought many radio commercials urging people to contact senators in opposition to the bill, contending it would "punish Kentucky families" and pushing an alternative measure that would bar people convicted of meth making from buying the medicines. Opponents of that bill say meth makers would continue to use surrogates to buy the medicines for them. Sen. Ray Jones, D-Pikeville, who voted for SB 50, called the radio ads "scare tactics." UPDATE: For more on the lawmakers' complaints about the ads, from cn|2 Politics, click here.

As of Feb. 3, the group had spent more than $82,000 running ads on Louisville, Lexington and Somerset radio stations owned by Clear Channel Communications Inc., the nation's largest radio operator, according to public-inspection files at those stations. In 2011, CHPA paid the Kentucky Association of Radio and Television more than $93,000 to run ads, according to public-inspection files from Cummulus Broadcasting, another major owner of stations in Kentucky.

UPDATE, Feb. 17: The drug makers have a 60-second ad from Pat Davis, who identifies herself as "a Kentucky resident for over 20 years" and the mother of six children who all "battle allergies." She is not identified as the wife of 4th District U.S. Rep. Geoff Davis, who is not seeking re-election. She testified against last year's bill. Here is the ad, via Page One Kentucky, a popular blog that has been critical of the legislation.

The drug makers' ads have been running uncontested for two months, but this week a group headed by Knox and Laurel County's Commonwealth's Attorney Jackie Steele, Real Facts About Meth, offered a counter-ad, describing the impact of meth on communities. The group does not appear to be well funded; its website solicits contributions.

Meds-for-meth bill could lead to overcrowding at doctors' office, Hopkinsville hospital official says

Making pseudoephedrine available only by prescription has led to fears of packed waiting rooms in doctors' offices, Dennis O'Neil writes for Hopkinsville's Kentucky New Era. (Photo of Sudafed pills by WebMD.com)

"It could lead to some overcrowding of primary care facilities that are already overcrowded," said James Goss, director of marking and community relations for Jennie Stuart Medical Center.

This session, three bills have been introduced to deal with pseudoephedrine, the key ingredient to make meth. House Bill 80 would prohibit anyone convicted with a meth-related charge from getting the drug without a prescription. The other two bills would prohibit anyone from getting the drug without a prescription, with the exception of pills in gel cap form.

Goss said he is worried a new law would inconvenience patients. "On its face, the bill seems well intended to protect the health and well being of the community," he said. "We are sympathetic to the pocketbook and convenience issues of our patients." (Read more)

Require all to have a prescription for pseudoephedrine, or just meth criminals? Officials debate the issue on KET

By Tara Kaprowy
Kentucky Health News

If something isn't done now about the prevalence of methamphetamine in Kentucky, "We're going to lose a generation." That was one of the jarring comments from one of the public officials who discussed ways to limit access to pseudoephedrine, the key ingredient in meth, Monday evening on KET's Kentucky Tonight.

The issue is one of the most contentious in the legislative session that began last week. There are two bills on the table aimed at quashing the problem, both sponsored by House Democrats.

Rep. Linda Belcher of Shepherdsville would make pseudoephedrine available only by prescription, but exempt the gel-cap version of the decongestant. Her bill would expire in three years, to give legislators an opportunity to assess its effectiveness.

Rep. Brent Yonts of Greenville would merely require the 5,500 Kentuckians who have already been convicted on a meth-related charge to have a prescription for the drug.

Belcher argued on the program that Yonts' bill "doesn't go far enough, it doesn't do the job," because meth cooks can pay others to buy the drug over the counter, while Yonts said his bill is a "middle ground" compromise. He asked, "Do we punish the whole population of Kentucky or do we punish those who have violated the law?"

Clay County Sheriff Kevin Johnson called into the program and sided with Belcher, saying "As far as putting the crooks on a banned list, that's not going to help the problem." Chris Cohron, Warren County commonwealth's attorney, said officers with the Kentucky Narcotics Officers Association "overwhelmingly support" Belcher's effort.

Maj. Tony King of the Jefferson County Sheriff's Office took an opposing view In order for pseudoephedrine to be made available only by prescription, it must be reclassified as a legend drug, he said, but those drugs are not tracked by MethCheck — the system that instantly tracks pseudoephedrine purchases at the point of sale — but by KASPER, the state's slower system for monitoring prescription drug abuse. "We will lose the ability to track these people and we will lose the ability track these labs," he said.

Meth-lab numbers continue to go up in Kentucky, reaching nearly 1,100 in 2010. Cohron said that is not the case in Oregon, one of two states that has passed a prescription law. He noted that in 2004, there were 472 labs in Oregon and 571 in Kentucky. In 2010, there were 13 in Oregon, and nearly 1,100 in Kentucky. Still, Yonts said Belcher's bill would punish people in all Kentucky counties for the problems of a relatively few counties.

Yonts argued MethCheck is working now, and his bill would merely strengthen what's in place. He said MethCheck stopped more than 14,000 attempts to buy pseudoephedrine last year. "All our surrounding states will very quickly have our system," he said. "CVS and Walgreens will inter-connect. It's a system that instantly verifies. It works." Cohron countered that 100,000 attempts were blocked in Oklahoma, which has a similar system, "but meth labs are still going up by 10 percent a year there. "Being reactive instead of blocking it is not going to solve the problem," he said.

Some callers to the show said Belcher's bill should not exempt gel caps, from which pseudoephedrine is more difficult to produce. Belcher acknowledged her bill is also a compromise and that 97 percent of meth labs use the pill version. Yonts said exempting the gel caps "just opens the door to another problem."

Panelists also discussed the issue of cost. Yonts said the state stands to lose up to $1 million in tax revenue if pseudoephedrine is reclassified as a legend drug, because prescription medication is not subject to sales tax. Belcher said the cost will be far greater, $1 million in manpower alone. "If we're looking at a tight budget, I'd certainly like to take that $1 million and use it for something that is more productive," she said.

Both Yonts and Belcher said they expect their bills to be heard in committee soon. In the meantime, Cohron, who said a generation is at stake if nothing is done, underscored the importance of dealing with the issue without being romanced by drug companies and lobbyists. "We're talking about a billion-dollar industry," he said. "They will spare no expense and they will stop at nothing to defeat it because it a billion dollars on the line."

To watch the show via KET videostreaming, click here.

Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.