Board Silent on Criticism of How It Handles Prescription Drug Abuse

Andrew Kitchenman | August 16, 2013 | Health Care
Members of state panel refuse to discuss policy described as ineffective and inefficient in investigative report

state Division of Consumer Affairs Director Eric T. Kanefsky urged the state Board of Medical Examiners to crack down on those who abuse their power to prescribe drugs.
The State Board of Medical Examiners drew fire in a recent state investigative report for its handling of doctors involved in prescription drug abuse, but board members won’t talk about the issue in public.

Members did not discuss the issue when the board met Wednesday, even though state Division of Consumer Affairs Director Eric T. Kanefsky was there to talk about the report and its follow-up.

And several board members wouldn’t answer a reporter’s questions about how they will respond to the prescription drug abuse problem, with some citing a board prohibition on any policy discussions outside of meetings.

Many regulators and law-enforcement officials said the board’s actions have been “weak and infrequent,” according to a July report by the State Commission on Investigation.

Kanefsky told the board on Wednesday that the public wants them to take action against those who abuse their authority to prescribe drugs.

Kanefsky said he asked to speak to the board “because New Jersey’s prescriber community plays a very important role in the fight against prescription drug diversion and abuse,” Buccino said. “He did believe it was important for the board to hear directly from him on the matter.”

The board has yet to take action in response to the SCI report. Kanefsky told board members that state officials are looking to take a series of steps to deal with the epidemic of prescription drug abuse.

“I’m sure you’re starting to appreciate this is an area where people are looking for the Board of Medical Examiners to take action,” said Kanefsky, whose division is responsible for protecting the public from fraud, deceit and misrepresentation in the sale of goods and services. As part of its responsibility to protect public health, the board adopts regulations and determines standards of practice, in addition to licensing, investigating and disciplining doctors and other health providers.

Kanefsky said that not enough doctors are using the state’s prescription drug monitoring program, which maintains a database of all controlled dangerous substance prescriptions dispensed by pharmacies.

He added that state officials are considering making all doctors register with the program, potentially requiring them to check the database before prescribing pain medications to determine where and when patients filled prior prescriptions and which doctors who prescribed them.

The state is increasing the number of drop boxes available at police stations for residents to dispose of unneeded or unwanted pain medications. Officials also are looking to increase the security features of prescription “blanks,” the sheets doctors use to write prescriptions.

“We are analyzing — and increasing, frankly — our enforcement and investigative efforts,” Kanefsky added, noting that this would lead to more enforcement actions being brought before the board.

Board members didn’t ask Kanefsky any questions or comment on the report at the meeting. The SCI report said many regulators and law-enforcement officials “contend that with regard to illicit drug diversion and improper prescribing of pain medication, the board’s actions have generally been weak and infrequent.”

The SCI report sketched out various scams in which doctors wrongfully prescribed pain drugs, such as the cases in which associates of Russian crime figures used Passaic doctor Joseph W. Dituro as a front to receive Medicaid payments and prescription narcotics.

Kanefsky noted that the board hasn’t taken action against all of the doctors listed in the report.

While he didn’t identify those whose licenses are still active, a search of the state database found that Dr. Randy Zeid has an active license, with practice locations in Camden and the Browns Mills section of Pemberton Township. The report alleged that Zeid presided over a “painkiller-prescription emporium” that resulted in the distribution of 10 kilograms of Oxycodone with a street value of nearly $10 million during a 19-month period.

Kanefsky said division officials are investigating all of the cases cited in the report and are aiming to “really make sure that we are utilizing the board’s authority over these individuals’ license,” and doing everything possible to protect the public.

The division has hired a former federal Drug Enforcement Administration agent to lead an effort to talk with doctors about best practices for prescribing potentially dangerous drugs.

“We encourage obviously you and all your colleagues in the medical community to participate and engage in these discussions,” Kanefsky told the board.

Urban Institute senior research associate Randall R. Bovbjerg said policing how doctors handle opioid drugs has been a controversial issue nationally, with the policy pendulum swinging between extremes of encouraging easy access to restricting access. The national Federal of State Medical Boards recently adopted a model policy that attempts to strike a balance.