WASHINGTON - Kentucky lawmakers are at the center of a political feud over the best way to derail interstate prescription pill trafficking, including the pipeline from Florida that plays a key role in what many see as an epidemic of drug abuse in Kentucky.

Republican U.S. Rep. Harold "Hal Rogers, whose Eastern Kentucky district is plagued by what one prosecutor called a "tsunami" of pills from out of state, favors one approach to track the flow of drugs. Reps. Ben Chandler and Ed Whitfield support an alternate plan, which competes with Rogers' for limited federal dollars.

From his seat on the powerful House budget committee, Rogers has had more success getting money for the program he favors, which is named after him.

Under that program, states get grants through the U.S. Department of Justice to set up or improve ways to monitor prescriptions for controlled substances such as pain pills and anti-anxiety medication.

Such systems are called prescription monitoring programs.

The program has funneled $48 million to 47 states and territories since 2002 for prescription-drug monitoring.

Whitfield, a Republican from Western Kentucky, and Chandler, a Democrat who represents Central Kentucky, support a program called the National All Schedules Prescription Electronic Monitoring Program, or NASPER. That program would set up uniform guidelines across the country on tracking prescriptions and require states to share information.

The program is managed by the Department of Health and Human Services.

That plan has gotten less than one-quarter of the $48 million it needs through federal appropriations.

"I requested $10 million to fund in 2010 in appropriations. It has been blocked because the committee is funding a competing program, the Hal Rogers Prescription Drug Monitoring Program," said Chandler.
"We think the NASPER program, because it provides a uniform national system, is the way to go. Congressman Rogers feels otherwise."

U.S. Rep. Ben Chandler, D-Versailles

Interstate pill trafficking could hardly be more serious anywhere than in Kentucky. Just last month, police from several different agencies started the largest drug raid in state history, targeting hundreds of people accused of selling drugs obtained through legal prescriptions from Florida.

One state police supervisor said the agency has information on 1,700 people traveling to Florida to get prescriptions.

One key reason people leave Kentucky to get drugs is the state's prescription-monitoring system, called KASPER. Doctors and pharmacists use it to check whether a person is going to multiple doctors to try to get drugs, and police use it to investigate drug dealing.
The system has worked so well that people seeking drugs to divert to the black market leave the state. The NASPER system is modeled on KASPER.

In part, philosophical differences are at work in the tug-of-war over funding for the different approaches to tracking drugs.

Rogers' program offers states a greater degree of autonomy in sharing information and prescription data with other states.

The Justice Department, which sponsors the Rogers grant program, believes the size and cost of a national database like NASPER may be prohibitive.

Critics accuse Rogers of blocking NASPER funding to ensure that the program named for him has no competition.

Rogers "has personally blocked the funding of NASPER because his fear is if this program gets funded his funding will stop," said David Kloth, a member of the Association of Interventional Pain Medicine, which pushed for passage of NASPER. "Here's a perfect example of one legislator worried about his legacy rather than what's best for everyone."

Rogers, however, strongly disputed that charge. A national program such as NASPER would prove too costly and unwieldy, he said.
"It's no secret that I prefer the Hal Rogers Prescription Drug Monitoring Program because it allows states to address challenges unique to their region and is supported through the Justice Department, which allows local law enforcement to monitor the illegal use of prescription drugs and help put unscrupulous doctors and dealers behind bars," Rogers said.

"NASPER is based out of Washington and is funded through HHS, which could preclude state and federal law enforcement officials from being part of this important process. Not to mention that a national program would create a huge, expensive bureaucracy that does nothing more than duplicate what we are already successfully doing at the state level."

U.S. Rep. Ed Whitfield, R-Hopkinsville

Some police said they applaud Rogers' efforts to address the issue of prescription-drug monitoring, but would prefer having a uniform, national tracking system, as long as officers could use it for investigations.

"Conceptually, I think a national approach is the best approach," said Ron Brooks, president of the National Narcotic Officers' Associations' Coalition.

Having a variety of state drug-tracking systems may create gaps or inconsistencies that people seeking to divert pharmaceuticals will try to exploit, several narcotics officers said.
David Gilbert, head of the Lake Cumberland Area Drug Task Force in Southern Kentucky and past president of the director of Kentucky Narcotic Officers' Association, said he often sees cases of people suspected of going to Tennessee to get prescriptions.
Tennessee has a prescription-monitoring system. But police access to the system is far more limited than it is to the Kentucky system, making investigations more time-consuming, Gilbert said.
Monitoring systems vary from state to state, are not formally linked and may have different rules on what information they collect and on access to the system, police said.
Some states have no system.

"That is the chief reason we're in the mess we're in in Florida," said Dave Keller, a retired FBI agent and director of the Kentucky section of the Appalachia High Intensity Drug Trafficking Area, which includes 66 counties in Kentucky, West Virginia and Tennessee, including more than a dozen in Rogers' district.

The National Association of Boards of Pharmacy has not taken a position on whether it supports Rogers' or Whitfield's approach to setting up prescription monitoring. However, officials with existing state programs have said a state-based approach is preferable, said Carmen Catizone, executive director of the association.

The association believes there should be national standards for what prescription information states should collect and report, Catizone said.
The grant program for drug-tracking systems that Rogers backs is developing a way for states to share prescription information.

Meanwhile, Florida lawmakers are consulting their Kentucky counterparts in their own efforts to stop out-of-state prescription drug seekers from frequenting the Sunshine State's cash clinics, where in the words of one lawmaker, getting pain pills is as "easy as picking up a Big Mac at a fast-food drive-through."

However, the proposed Florida program isn't equipped to share data nationally - a requirement of NASPER and something strongly advocated by law enforcement, physicians and pharmacists.
A law passed by the Florida General Assembly in July requires that a prescription monitoring system be created by Dec. 1, 2010. But despite the new law, there will be no prescription monitoring system in Florida without federal grants or private funding, said Florida Department of Health spokeswoman Eulinda Smith.

Smith said Florida will apply for grants for the system through the Hal Rogers program.

"We will not be able to apply for NASPER funding until there is legislation allowing for our data to be shared with other states," Smith said.

Still, Whitfield and other lawmakers are encouraged by the Obama administration's support for the NASPER program.
"President Obama had NASPER in his budget this time and we know there's support," said Whitfield, of Hopkinsville. "I'm quite confident that NASPER will be funded and will be increased every year."