Pharmacy Board Stalls Drug Abuse Prevention Efforts, Advocates Say

You may remember Katy.

She’s 24, an addict in recovery who appeared in the first story in this series.

When we met at a local Dover restaurant, she told me where she’d look for drugs.

"Check the medicine cabinet. That used to be my go-to thing. New house, check the medicine cabinet."

What would she find?

"Sometimes nothing, sometimes Percocets, anything that was narcotic, I’d take it, Tylenol with codeine, drink some of it or all of it, put some water back in there, you name it."

Katy tells a very common tale.

As the number of legitimate prescriptions for painkillers and other opioids has soared over the past decade, so too has abuse.

According to the National Survey on Drug Use and Health, more than 60 percent of the pain relievers misused or abused nationwide come from family and friends.

Most are shared freely; others are sold or stolen.

And they can be deadly.

Melissa Heinen is an educator with Northern New England Poison Center.

She has these statistics just from the state of New Hampshire.

"From 1995 to 2000 we had less than one death a week, but from 2000 to 2007 we’ve increased to three deaths a week. I share that with high school students and their jaw just drops."

Those overdose deaths are, in part, attributable to New Hampshire’s extraordinarily high use of the painkiller methadone.

We’re fourth in the nation for per capita consumption.

Despite those statistics and others, at least two of the New Hampshire Board of Pharmacy’s six appointed commissioners do not believe that the state has a serious problem with prescription drug abuse.

And if there is a problem, they say, it’s not the Board’s to solve.

Ron Petrin is the vice president of the Board of Pharmacy, and the owner of Bedford Pharmacy.

Despite evidence to the contrary by the state’s Medical Examiner, Petrin says he doesn’t believe the state has a serious prescription drug problem.

"No one has been clamoring, I haven’t seen any communication from anyone indicating we’re near a crisis mode or things have gotten a lot worse in the past -- in the recent past."

And while the number of overdose deaths fell from 2007 to 2008, State Medical Examiner Tom Andrew, says this year, the trend is still heading up.

"We’re certainly on pace to be right where we have been for the last several years, and that’s somewhere between 140 and 150 drug deaths over the course of the year."

Sandra Keans is the Board of Pharmacy’s only non-pharmacist commissioner.

Keans concedes that some people abuse medications and some overdose on them.

But, she says, she doesn’t see how the board of pharmacy can stop them.

"I think we think there’s a mental health problem out there that probably needs to be addressed someplace else."

That opinion is having an effect on how the state tackles the issue.

For example, thirty-nine states, including all of our neighbors, have installed prescription monitoring programs.

They allow health care providers to keep track of which patients are getting what drugs.

But privacy rights advocates and New Hampshire’s Board of Pharmacy have lobbied against such a program.

Commissioner Sandra Keans:

"We have never been supportive of any of the programs that have been proposed. We understand that there’s a problem and that monitoring is a good idea. But not at the sacrifice of personal privacy."

Supporters of drug monitoring programs argue that they keep addicts from running from doctor to doctor looking for drugs.

The New Hampshire attorney general’s office supported the idea, but says Keans, that didn’t matter.

"An awful lot of people jump when the AG’s office says we have to do this. We do not jump at that kind of thing because the AG says it’s going to be OK."

In another effort at trying to address the problem of prescription drug abuse, Melissa Heinen at the Poison Center joined forces with Cyndi Desrosiers at Allies in Substance Abuse Prevention, in Portsmouth.

This past spring, the two groups asked the Board of Pharmacy to require the state’s pharmacies to display educational posters about proper storage and disposal of narcotics.

The board refused.

Board Vice President Ron Petrin explains why.

"It’s asking a lot of us, we’re understaffed, underpaid, under-everything in this budget crunch."

Desrosiers and Heinen also asked the board to have pharmacists attach informational flyers to packages containing narcotics.

Again, the board said no.

"We try to restrict the amount of things that we force our professionals to do. To force someone to have to attach an additional piece of paper to the package they give out is in my personal opinion too cumbersome."

The resistance came as a surprise to Desrosiers and Heinen.

"We were shocked! New England Poison Center and I left and we were absolutely shocked by the response of the Board of Pharmacy."

The board has agreed to post on its web site instructions for disposing of prescriptions in ways that don’t harm the water supply.

The Department of Environmental Services is writing those guidelines now.

In the meantime, drug abuse prevention groups want to find ways to keep pharmaceuticals from getting into the wrong hands.

Northern New England Poison Center’s Melissa Heinen:

"If we can get rid of expired or unwanted medications from our house, we feel that we might decrease accidental poisonings or little kid poisonings, we may prevent diversion of someone coming into your home and then taking some as well as preventing some of the young adults from taking a pill here or there and then bringing it to a party and sharing them."

Police departments around the state have been looking into programs to collect unwanted medications.

Such programs aren’t new.

The state of Maine, for example, encourages residents to send unused drugs to a local department of the DEA.

Here in New Hampshire, the U.S. DEA has given the Seabrook police department permission to set up a collection box that will be available 24 hours a day.

But Sandra Keans says the Board of Pharmacy opposes police take-back programs.

"One, we think there may be a legal problem of them having possession of it without a pharmacy license. Two, how do the police then get rid of it, and three, what makes you think people want to go to the police department and turn in drugs?"

Many programs across the country collect hundreds of pounds of pills; a few have collected thousands of pounds.

The Board of Pharmacy says it interprets state law to say that police can’t run such collection programs.

However, the law in question, The Controlled Drug Act, does not address them.

The AG’s office says it has not yet interpreted the law.

In the meantime, Seabrook Lieutenant Mike Gallagher says he reports to the AG’s office, not to the board of pharmacy.

And he’s not letting the board’s opposition block the program.

"We hope to start it as soon as we can, hopefully within the next few weeks."

Gallagher, who investigated five drug overdoses in Seabrook in a single year, says his reason is simple.

He hopes getting rid of some drugs will prevent at least one more death.

For NHPR News, I’m EG.