A computer program designed to alert health care professions to potential drug-seeking patients remains plagued with technical problems.
“It’s very sad, and I often feel dejected by the fact that it’s taking so long,” Bob Pack said.
Pack proposed the Controlled Substance Utilization Review and Evaluation System (CURES) in 2006. His wife and two young children were killed by a hit-and-run driver who was under the influence of prescription narcotics.
”Year after year, the costs in lives and families being torn apart just increases as everybody sits on their hands, just wasting a lot of time,” he said.
More than 1,000 Californians die every year from accidental or purposeful abuse of controlled substances.
The CURES database is administered by the state Department of Justice. It contains records of all controlled substances prescribed by California health care providers and the names of the patients who got those powerful medications.
Before doctors write a new prescription for a patient, they can check the database and find out if those patients have been “doctor-shopping” to stockpile narcotics, sedatives, stimulants and other potentially dangerous medications. If so, providers can question those patients about possible drug addiction and help them get treatment.
“If I’m aware that they’re getting multiple prescriptions, I can intervene right away,” Dr. Clark Smith, a San Diego pain medicine and addiction expert, said. “Information from CURES can also help me treat addicts before they relapse.”
In other states, health care providers are required to register for, and use, a CURES-like database. But in California, the use of the CURES system remains optional for health care providers and pharmacists.
Earlier this year the State Senate passed a bill (SB 482) that would require doctors to check the state’s narcotics database before they prescribe controlled substances for new patients. It also would require doctors to annually check the database if the course of narcotic treatment continues for the patient. In the proposed bill, doctors who don’t check the database would be disciplined.
A 2012 state law did required providers and pharmacists to register for the CURES system by January 2016. But on Oct. 11, Governor Jerry Brown approved a six-month extension on that registration deadline to July 1, 2016.
It’s unclear why the delay is necessary. Kristin Ford, a California Department of Justice (DOJ) spokesperson told NBC 7 Investigates “a new, state-of-the-art CURES system, ('CURES 2.0') with greatly improved infrastructure and a fully-automated paperless registration system” is ready to go.
Ford said the problem is many health care providers don’t have the high security internet browsers needed to access the CURES database. For that reason, DOJ “informally supported” the six-month registration delay.
The author of the bill that extended the registration deadline said his legislation was necessary “... because the updated version of CURES is not fully operational at this time, and (health care providers) need an additional six months to comply with statutory registration mandates.”
Pack blames the California Medical Association (CMA) for continued delays in implementing the CURES system. He said the CMA, which supported the recent six-month registration delay, “continues to oppose CURES and find ways to play defense, and deflect the objective of safety for patients.”
The CMA disagrees. The Association says it supported the legislation that required doctors and other providers to register for CURES and increased physician licensing fees to help fund the CURES database. “Physicians support the CURES database and want to have it as a tool in their clinical practice,” according to a statement from the CMA.
As of this week, Ford said there are more than 57,600 approved CURES registrants.
Consumer Watchdog, a consumer lobbying group which supports mandatory use of CURES, says it was told only 20 to 25 percent of California’s doctors are currently registered for the database.
Dr. Smith, who also supports mandatory registration and use of CURES, told NBC 7 Investigates his office has been unable to access the database since it was upgraded in July.
“If I have patients who are taking dangerous amounts of drugs from multiple providers, I can’t find out about it,” Smith said. “They could die of an overdose.”
He said he has contacted the California Department of Justice about his inability to log into CURES, but has not gotten any help from the agency. “It’s the run-around,” Smith said.