House panel hears about 'pill mill pipeline'

McClatchy NewspapersApril 14, 2011 

WASHINGTON — Kentucky Gov. Steve Beshear and Florida Gov. Rick Scott, whose states anchor either end of what's known as the "pill mill pipeline," testified Thursday on the destructive underground prescription-drug network that weaves its way up from Florida's pain clinics to Kentucky's Appalachian mountain communities.

The governors, along with the Obama administration's drug czar and victims and survivors of pain pill abuse, said Thursday at a House Energy and Commerce subcommittee that the selling and abuse of prescription drugs — especially OxyContin — had grown to epic levels.

The problem is so entrenched that the cheap flights and van rentals that drug traffickers use to travel from Florida, with its looser laws on pill distribution, to Kentucky and other states are nicknamed the "OxyContin Express."

"Let me be frank. Our people in Kentucky are dying," Beshear said. "Eighty-two people a month. More people in Kentucky die from overdoses than car wrecks."

Ninety-eight of the top 100 doctors in the country dispensing oxycodone — the generic form of OxyContin — are in Florida, mostly in Miami, Tampa and Orlando, Scott said.

"More is dispensed in Florida than the rest of the country combined," Scott told the panel.

It was a rare moment of unity for the two governors. Their previous ideological differences over whether Florida should implement a prescription-drug monitoring program drew members of Congress from both states and the Obama administration into the fray. Scott objected to such a program, citing privacy concerns, and turned down a $1 million donation from pharmaceutical giant Purdue Pharma, the maker of OxyContin, that was meant to help pay for a prescription database to combat Florida's illegal trade in painkillers.

Scott has since backed away and now says he won't block the database. But he said Thursday that he was still worried about a potential breach of security.

During the hearing, he told Rep. Marsha Blackburn, R-Tenn., that private companies, not pharmaceutical firms, were putting up the money to fund Florida's prescription-drug monitoring program for two years. Scott, along with the state's attorney general, launched a statewide strike force last month to take a law enforcement approach to the problem.

"If we have a database that I can deal with — and we're going forward with the database; it passed last year — my focus is making sure we deal with the privacy concerns," Scott said after the hearing. "There are many citizens all across our state that are very worried about their personal data being in a database, and so I'm going to be very focused on making sure I deal with those privacy concerns."

Beshear, whose state has long had law-enforcement and treatment programs in place and whose prescription-drug monitoring program is a model for other programs across the country, said that in the 10 years since the database had been implemented Kentucky had never had a security breach. Kentucky's program is funded with taxpayer dollars.

"The fact is no state is an island," Beshear said. "It doesn't have to be identical everywhere but it does have to be everywhere for it to work."

According to a study by the Substance Abuse and Mental Health Services Administration, there was a fourfold increase nationally in treatment admissions for prescription pain-pill abuse during the past decade. The increase spans every age, gender, race, ethnicity, education, employment level and region.

The study also shows a tripling of pain pill abuse among patients who needed treatment for dependence on opioids — prescription narcotics.

Kentucky often ranks at or near the top in U.S. measures of the level of prescription pain-pill abuse. As far back as 2002, one-fourth of OxyContin-related deaths in the country took place in eastern Kentucky.

As he did during a recent tour of Appalachian areas that have been hit especially hard by the prescription-drug abuse epidemic, White House drug czar Gil Kerlikowske called Thursday for a multi-pronged approach to the problem.

Beshear said he was "very excited and pleased" to hear that Florida was moving ahead with a drug database.

"Obviously there is no single answer to this problem, but that is a very effective tool," Beshear said. "It's proven to be very effective in this area. My goal is to have all 50 states have a monitoring system like this, because when we do it will cut down significantly on the illegal use of these drugs."

ON THE WEB

The Alliance of States with Prescription Monitoring Programs

MORE FROM MCCLATCHY

Florida drug database a 'go,' despite Gov. Scott's objection

'Pill mill pipeline' creeping into rural Georgia

OxyContin abuse spreads from Appalachia across U.S.

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