Trailing an elusive killer

Brandi Lynn Kanthak doesn’t look like the victim of drug abuse.

Her photo on the website of an Acworth surgical clinic shows a smiling and self-assured young woman.

At 24, she was the girl who had life mapped out: get married, work her way through school to become a nurse, name her future baby Sydney.

She didn’t plan on her life being cut short in February 2010 because of an addiction to the prescription pain killer Demerol.

“She hid it from not only me, but her husband and the people around her at work and school,” said Kanthak’s mother, Barbara Pruitt. “No one noticed it.”

Pruitt is among many Georgia residents, medical workers and law enforcement officers who are eager for a recently approved prescription drug monitoring database to become reality. Tracking who is getting potentially addictive prescriptions — and how much — will save lives by identifying drug abusers who could be saved by treatment, they argue. But state lawmakers who approved establishing the database did not provide the $400,000 to $1.2 million it could take to get a system up and running. The state, which is cutting college funding and borrowing from Medicaid to prop up the pension system, doesn’t know how or when it will get the money to start the database.

Funding to start the system could come from drug companies or the state could win a federal grant. But it will be at least 2013 before the database is online.

That’s because the state Drugs and Narcotics Agency, charged with its setup, is moving slowly to figure out how to best organize the database.

Agency head Rick Allen expects that to be more clear late this summer, far too late to meet a mid-May deadline for federal money.

“There is a lot of concern over future funding if the grants dry up or Georgia doesn’t qualify because of how tight the restrictions are that were written into the bill,” Allen wrote in response to questions from The Atlanta Journal-Constitution about the database.

Those restrictions were needed to get the measure passed. The database would allow physicians and pharmacists to review their patients’ prescription history for controlled substances that can become addictive — usually pain killers. Prescriptions for antibiotics, blood-pressure pills and other medications that are not addictive won’t be tracked.

But the Georgia information cannot be shared with any other states or the federal government. That change was made after privacy concerns were raised by some state lawmakers. It could disqualify Georgia for federal aid.

Jack Killorin, who heads a federal anti-drug task force in Atlanta called the Atlanta High Intensity Drug Trafficking Area, hopes a database will facilitate treatment, not arrest.

“The best answer, if someone has become addicted to prescription pain killers, is that a physician will address that in the course of treatment,” he said. “We can get people early on before they are seriously addicted.”

That’s what Pruitt wished had happened with her daughter, although there is no guarantee a database would have detected her drug use. Kanthak was forging prescriptions using a friend’s name to satisfy her addiction. But no one was tracking just how many she was writing.

Pruitt thinks the public is unaware of how deadly prescription drug addiction is. There were 584 prescription drug overdose deaths in Georgia in 2009, according to records from the GBI Medical Examiner’s Office. By comparison, there were 86 deaths from illegal drug overdoses.

For all of the potential benefits of a database, some doctors and pharmacists say they are not comfortable policing patients.

“We have no way of knowing the patients are the criminals,” said Dr. Marion O’Neill Lee, a pain management physician in Tifton.

He said he has tried to call pharmacies on patients he suspects are abusing or dealing but calls such efforts inefficient in getting at the root of the problem.

“The real key is to give legitimate physicians the ability to practice their medicine,” Lee said. “We want to work on a database, and hopefully that will stem the tide.”

Some independent pharmacists have decided not to carry Oxycontin and other highly addictive prescription medications to avoid becoming a target for addicts and pill pushers.

“We don’t stock it, so no one breaks in for it and none of the wrong people get the prescription,” said Bobby Harrell, a pharmacist who co-owns Briarcliff Pharmacy in DeKalb County. “But I’m running off legitimate customers who might become regular customers once they’re over their pain from surgery or what have you.”

But most pharmacies carry the highly addictive drugs, and the fact that Georgia hasn’t found the money to begin tracking who’s getting drugs concerns those who think the database will help get addicts treatment.

Purdue Pharma, which makes Oxycontin, recently offered $1 million to fund Florida’s prescription drug monitoring program. Purdue Pharma is “open to” working with the state, spokeswoman Libby Holman said.

Rep. Tom Weldon, R-Ringgold, helped push the database through the Legislature this year but worries that without funding the idea will wither.

“It benefits them to get a handle on this so their products can stay legal and safe for those who need it,” Weldon said of drugmakers and large pharmacy companies. “I don’t think this is the be all to end all, but it is a strike near the heart of the problem once we get it going.”

Allen said Drugs and Narcotics is starting its process to apply for a federal Department of Justice grant to seed the project.

The agency also wants to figure out how to absorb costs into its annual budget, even though with cuts to spending it now has the same number of investigators as it did when it was founded in 1976.

The next step likely will be meetings with the state pharmacy and medical boards on the mechanics of the database, Allen said.

Eventually, there will be training sessions on how to best use the information and, it is hoped, a system that works to curb abuse. The experiences of the 34 states that track prescriptions, Allen said, will help Georgia.

“Since we’ve never done this before, other states have cautioned us to not rush it into existence,” Allen said. “It’s sort of a get-it-as-right-as-we-can the first time.”