Drug czar unveils plan to attack prescription drug abuse

McClatchy NewspapersApril 19, 2011 

WASHINGTON — The Obama administration on Tuesday unveiled a plan to fight prescription drug abuse, warning that accidental fatal overdoses now exceed the combined deadly overdoses from the crack epidemic of the 1980s and black tar heroin in the 1970s.

The initiative to combat the nation's fastest-growing drug problem includes boosting awareness of the dangers of prescription drug abuse among patients and health care providers, cracking down on "pill mills" and "doctor shopping," and requiring drug manufacturers to develop education programs for doctors and patients.

"Too many Americans are still not aware of the misuse and abuse of prescription drugs and how dangerous they can be," said Gil Kerlikowske, the White House director of national drug-control policy.

Accidental drug overdoses are now the leading cause of accidental death in 17 states — ahead of car crashes — Kerlikowske said. They account for seven a day in Florida, one of the epicenters of the epidemic and the source of much of the drugs. In Broward County alone, more than 1 million pills are dispensed every month, according to the Broward Sheriff's Office.

The plan calls on every state to develop a prescription drug-monitoring program and encourages them to share the information with other states. Thirty-five states already have such monitoring programs in place, Kerlikowske said.

The initiative recommends convenient ways to remove and dispose of unused and expired medication from the home. Kerlikowske noted that seven out of 10 prescription drug abusers obtained their drugs from friends or relatives. A national "take-back" effort last September netted more than 121 tons of prescription drugs in a day, he said. Another take-back day is scheduled for April 30, Drug Enforcement Administration head Michele M. Leonhart said.

The plan also calls for the drug control policy office and the DEA to step up enforcement by targeting training to states with the highest need. Law enforcement agencies and the lawmakers who represent them have long complained that clinics where pain medication often is dispensed without prescriptions, or "pill mills," contribute heavily to the prescription drug epidemic.

Kerlikowske said his office would ask Congress for an increase in funding for drug prevention of $123 million and for treatment of $99 million for 2012, to train primary health care providers to intervene in emerging cases of drug abuse and to expand and improve specialty care for addiction.

As part of the initiative, the Food and Drug Administration will require the makers of a certain class of drugs — "extended-release and long-acting opioids" — to work together to develop an education plan to help doctors and patients.

Opioids — such as morphine and oxycodone — are used to treat moderate and severe pain.

The announcement came on the heels of Kerlikowske's testimony last week before a House Energy and Commerce subcommittee about the destructive underground prescription-drug network that weaves its way up from Florida's pain clinics to Kentucky's Appalachian mountain communities. Kerlikowske, Kentucky Gov. Steve Beshear and Florida Gov. Rick Scott — whose states anchor either end of what's known as the "pill mill pipeline" — stressed that sales and abuse of prescription drugs, especially oxycodone, had grown to epic levels.

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.

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.

ON THE WEB

Office of National Drug Control Policy news release

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