The warning across the top of the California Attorney General’s Prescription Drug Monitoring Program website comes right to the point:

“The California Department of Justice cannot respond to telephone inquiries or emails to the CURES/PDMP Program due to budget-related resourcing issues. We regret the inconvenience.”

And an inconvenience it is, but not only for those using the 100-million-record database as designed―pharmacies and doctors that track patients who might be getting prescriptions from multiple sources. It’s also a problem, as the Los Angeles Times pointed out in its investigative series on an epidemic of prescription drug deaths, for prosecutors and state medical watchdogs trying to police overprescribing doctors.

The CURES database has been off-limits to the public and the news media since its inception in 2009. But it is accessible, with the help of the state Attorney General’s office that manages it, by law enforcement and state regulatory agencies, in addition to doctors and pharmacists. When in full operation, CURES responds to about 60,000 inquiries a year from doctors and pharmacists.

For various reasons―including budget restraints, policy priorities, politics and convenience―neither the Attorney General’s office, law enforcement nor the state Medical Board that oversees physicians have utilized the database much to track down corrupt or negligent doctors who are illegally prescribing boatloads of drugs to the addicted and undeserving, often to the detriment of their patients.    

Overdoses have been steadily rising for years. Unintentional opiate painkiller-related deaths rose from around 3,000 in 2000 to more than 15,500 in 2009, according to the Centers for Disease Control and Prevention.

The Times, using information from a commercial database with the same kind of data as CURES, illustrated how easily that information could be used to bust bad docs. The newspaper used the data that pharmacies sell to manufacturers for marketing purposes and conjured up a Top 10 list of Los Angeles’ busiest doctors in June 2008.

Six of the 10 were eventually convicted of drug dealing or similar crimes. At least 20 of their patients died from overdoses or related causes. The Times detailed dozens of cases of abuse and death that might have been prevented by mining of CURES data and aggressive prosecutions.

The Attorney General’s office pleads poverty. They don’t have the manpower to handle the database inquiries from outside sources, conduct their own database analysis or mount investigations of doctors. Their focus is on patients. Budget cuts earlier this year reduced the staff overseeing the database to part-time and, although CURES is a model for 36 states with similar programs, it is in jeopardy of running out of money.

And when the Medical Board was asked why they don’t use CURES, the answer from Executive Director Linda K. Whitney was simple.

“We don't have the resources,” she said.

–Ken Broder

To Learn More:

Dying for Relief (by Lisa Girion and Scott Glover, Los Angeles Times)

CURES Database Tracks Suspicious Prescription Activity (by Frederick Ray, California License Law Blog)

Prescription Drug Monitoring System Running Low on Funds (by Christina Jewett, California Watch)

Prescription Drug Abuse Rising as State Cuts Monitoring Program (by Ken Broder, AllGov California)