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Florida's computer-toting investigators attack prescription abuse

The scenario had become frequent in south Florida: A doctor would open a ''stress clinic'' to attract young drug addicts as patients, give them cursory examinations, then prescribe a month's supply of Quaalude pills for $100.

The scam worked as long as no one checked for unusual patterns in the sale of prescription drugs. But the number of deaths from overdoses of Quaaludes in Dade County (Miami area) climbed steadily until it reached 78 in 1982.

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Those figures helped confirm a federal General Accounting Office report that said more people died from overdoses of prescription drugs than all the illegal and street drugs combined.

Spurred by those numbers, the Florida Legislature outlawed the use of Quaaludes in 1982. That state law went into effect two years before the US Congress passed federal legislation, and many of the doctors who had set up the stress clinics had their licenses revoked. The number of deaths in Dade County from Quaalude overdose dropped to 23 in 1983.

The state has cracked down on health-care professionals who abuse their licenses to prescribe drugs by sending investigators armed with small computers to drugstores. There they comb through records of the sales of controlled drugs.

The investigators work for the Florida Department of Professional Regulation. Fred Roche, the department's secretary, said its methods are drawing interest from other states.

''We are the only agency in the state that has any authority over the use of legal drugs,'' Mr. Roche said, ''because we license pharmacists, doctors, and nurses.''

The department has been examining pharmacy records since the Legislature mandated the investigation in 1980, he said. But it wasn't until recent months that Florida became the first state to employ briefcase-size computers to help speed up the process. An investigator now can check through even the largest drugstore's records in seven hours.

After recording into the computer three months of prescription records, the investigators will look for patterns of people who obtained an unusually large number of the pills, or of prescribers who have dispensed unusual amounts.

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Roche said that since 1980 his department has investigated cases against nearly 2,700 of the 53,000 health-care professionals in the state who prescribe or dispense legal drugs.

Those cases brought by the department include 556 medical doctors, 1,034 nurses, 838 pharmacies and pharmacists, 105 osteopathic physicians, 108 dentists , 30 veterinarians, seven podiatrists, and a naturopathic physician. Punishments have ranged from the loss of licenses to reprimands, Roche said.

''In some cases, the doctors sincerely felt they were doing a good service by helping relieve pain,'' Roche said, ''and sometimes doctors have been duped by professional addicts who go around to different doctors. But in most cases the doctors were abusing their prescribing privileges.''

The Department of Professional Regulation also is gathering information from the order forms that doctors and pharmacies must use when they are purchasing drugs identified as particularly likely to be abused.

That informaton is put into the program's computers to determine which prescribers are ordering unusually large amounts of controlled drugs for their office use and which drugstores are receiving inordinate supplies.

By checking the amount ordered vs. the amount being prescribed, the state can determine if significant quantities of the drugs are being diverted.

Roche listed the following highlights of his department's investigations:

* A Panama City physician, who had maintained inaccurate records of controlled substances by fraud and subterfuge, had his license revoked.

* A Tamarac osteopathic physician, who had prescribed 21,000 dosage units of Dilaudid during a six-months period, relinquished his license to avoid further disciplinary action.

* A Miami pharmacist, who had filled a large number of Quaalude prescriptions for stress clinics, relinquished his license to avoid further disciplinary action.

* A Miami physician, who was found guilty of excessively and inappropriately prescribing 149,905 Quaalude pills during one year, had his license revoked.

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