Everybody Hurts: Victimized by Prescription Drug Abuse, Father Finds a Cure

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February 11, 2013

Bob Pack could have fallen apart.

He lost his two children in October 2003: 10-year-old Troy and 7-year-old Alana. They were killed by a driver high on painkillers who ran them over on a California street.

The driver, Jimena Barreto, fled the scene and wasn’t found until two days later. She was tried and convicted of murder in 2005. Cecilia M. Vega at the San Francisco Chronicle wrote:

In the end, it was Barreto's own admission to police that prosecutors hoped would prove their case. She told police that on the day of the crash, she took at least eight Vicodin and muscle relaxants before getting into her car.

Investigators found that she had gone from doctor to doctor to get new prescriptions for painkillers, including doctors at the same hospital. Pack was incredulous. How could it be that in Northern California – the heart of digital innovation – that no one had been tracking these prescriptions and connecting the dots that would have stopped Barreto from getting access to painkillers? Lisa Girion and Scott Glover at the Los Angeles Times wrote:

Pack, a technology entrepreneur, learned that California pharmacists were required to submit detailed data to the state on the controlled substances they dispensed. The information includes the name of the patient and the prescribing physician, as well as the drug and dosage. The information is stored in the Controlled Substance Utilization Review and Evaluation System — CURES. The system has been in operation in various forms since 1939.

In theory, the database could be used by doctors, pharmacists, hospitals, law enforcement officials, or the state medical board to monitor prescribing patterns and patient histories. If Barreto showed up at a doctor’s office complaining of pain, a doctor could call the CURES office and ask for her prescription history. From the trial evidence, it seems that doctors would have found out that Barreto already had filled several prescriptions for painkillers. A responsible doctor would have declined to give her a new prescription.

But, despite its optimistic name, CURES was anything but. Instead of someone on the other end of the line giving a doctor the necessary information to make an informed prescribing decision, the underfunded CURES office developed a backlog of requests that took weeks to answer. If a doctor couldn’t find out about drug-seeking behavior while the patient was in the office, what good was the system? Glover and Girion wrote:

Pack devised a plan for real-time access to the database. He and some Silicon Valley friends helped design an Internet portal that would allow medical professionals to review a patient's history of medication use while considering whether to prescribe or dispense new drugs. … Pack also pitched a separate component that would automatically alert state officials to doctors with suspicious prescribing patterns. In a recent interview, he called it a "built-in red flag system" that would deliver reports weekly or monthly.

Jerry Brown, now California’s governor, was attorney general at the time, and he signed onto the idea with great enthusiasm and held a press conference in 2009 with Pack to announce the new program.

Pack told the Danville Express at the time, "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."

Things didn’t work out that way. More on that in my next post.

Image by Kathea Pinto via Flickr