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Overdose death reporting to boards short-circuited in state law

In 2013, 593 Oklahomans died from overdoses involving at least one prescription drug—one of the highest rates in the nation—but the state’s system of reporting fails to inform the state medical board about overdose deaths so that the board can investigate any links with the physician prescriber, says a report by Oklahoma Watch and the newspaper the Oklahoman.

The deaths of overdose victims such as Dena Kay Brasfield are only now beginning to shine a light on the dysfunction of the reporting system. Brasfield died of an overdose in 2010. Two days prior to her death, her physician, Cecil Allen Moore, had prescribed her unusually large doses of the anti-anxiety drug, aplrazolam, in response to her complaints of migraines and anxiety.

Despite the unusual dose size, her death was never reported to the board. It took almost two years of complaints by pharmacists, patients, and relatives to spur a board investigation of Moore. What they discovered was troubling. In 2010 and 2011, overdoses had resulted in the deaths of eight of Moore’s patients.

This is by no means an exceptional incident. Of the 534 overdose deaths of Oklahomans in 2012, about half were due to prescriptions from their own doctors. The report found many instances of doctors who in one or two years’ time saw the deaths of four or five patients.

Prior to the investigation, this sort of data has been difficult to access due to the fact that neither the medical examiner’s office nor local law enforcement authorities tend to report the names of the prescribing doctors in overdose cases to the relevant licensing boards.

When reports of over-prescribing physicians do finally reach the boards, usually due to private complaints, its unusual for them to take any disciplinary action. The two primary licensing boards in Oklahoma have only sanctioned 11 physicians since 2007; of these, four are still practicing in the state.

Criminal cases against over-prescribers are even less common: only one criminal charge has been filed in the last two years.

Read more about the report here.