Eastern Kentucky's legacy of prescription drug abuse has been well publicized over the past few years, making both local and national headline news. Back in April 2004, after 211 alleged drug dealers were arrested in Hazard, Kentucky, the largest drug bust in the state's history, it prompted MSNBC to call eastern Kentucky the "...ground zero of prescription-painkiller abuse." The media reports got the attention of Kentucky Congressman Hal Rogers.

After House Bill 26, which called for the delivery of a pilot pharmaceutical monitoring system in eastern Kentucky, passed in the 2002 Kentucky legislature, Congressman Rogers took action by helping to get that project off the ground in Perry and Harlan counties. The pilot was designed to test a new electronic method of monitoring the prescription drug process. Now the results of that pilot are nearing completion.

The Kentucky Cabinet for Health Services implemented a Schedule II-V prescription-reporting program called Kentucky All Schedule Prescription Electronic Reporting (KASPER) in January 1999 with the passage of Kentucky Revised Statutes (KRS) 218A.202. The schedules range, for example, from Oxycontin (a schedule II narcotic) to Robitussin AC, a schedule V narcotic. Illicit drugs such as cocaine and heroin are considered schedule I drugs. The system was originally housed in the Cabinet's Public Health Department. With the recent reorganization of state government in Kentucky, the system, along with the entire Drug Enforcement and Professional Practices Branch (DEPPB), was moved to the Cabinet's Office of the Inspector General.

The KASPER system currently produces in excess of 475 reports per day. The reports detail Schedule II-V drugs dispensed by pharmacies, dispensing physicians, dispensing veterinarians or other Kentucky licensed dispensers. A private contractor, Atlantic Associates Inc. (AAI), collects all data and manages the technical aspects of the data collection from the commonwealth's 2,300 reporting dispensers.

The primary focus of KASPER has been to enable physicians and pharmacists to better manage the care of their patients and customers and it is these practitioners who greatly utilize the system. In addition, pharmacists and investigators in the DEPPB review and analyze the data collected. These reviews often identify potential cases of doctor shopping, drug diversion, drug over-utilization, misuse or over-prescribing. Where allowed under the law, suspected patients, prescribers and dispensers are referred to the appropriate practitioners, law enforcement agencies, professional licensing boards or other agencies. Law enforcement and regulatory agencies also request reports to aid in their existing investigations of illegal drug diversion.

All pharmacies, dispensing physicians, dispensing veterinarians or other licensed dispensers in Kentucky who dispense prescriptions in Schedule II, III, IV and V drugs are required under KRS 218A.202 to report. (Reporting is not required for controlled substances dispensed to hospital inpatients, skilled care patients or intermediate care patients.) A record of each Schedule II-V prescription dispensed must be completed and submitted to AAI twice a month.

Since the start of the pilot project, but unconnected to the pilot, the KASPER system has undergone modifications which will include more timely and up-to-date reporting by pharmacists to the system. Under a new contract with AAI, the KASPER system will begin collecting data weekly. New regulations are being written to require dispensers to report weekly. This will reduce the delay in data collection by half. Other enhancements to the KASPER system include a secure Web enabled application