WASHINGTON — The White House drug czar and the state attorneys general of Florida and Kentucky told Congress on Thursday that prescription drug abuse is "a national crisis" and efforts to fight it will falter without better cooperation between states and better education of the medical community and the public about its dangers.
Gil Kerlikowske, the director of the Office of National Drug Control Policy, said that the issue was "not on the radar screen" until recently, but that prescription drug overdoses, commonly from a pain medication called OxyContin, have become the leading cause of accidental death in the U.S., surpassing gunshot wounds and car crashes.
It's an economic problem as well, costing health care providers, employers and taxpayers $56 billion in 2007, he said.
"We weren't paying attention to it," Kerlikowske told the House of Representatives Subcommittee on Commerce, Manufacturing and Trade. "That was a huge mistake."
About 100 people die every day from drug overdoses, and while high-profile examples such as Anna Nicole Smith and Michael Jackson get the most attention, it's a nationwide problem.
Kentucky Attorney General Jack Conway said prescription drug abuse has a devastating impact on poor, rural communities, particularly in eastern Kentucky, where it accounts for a large percentage of crime. Conway described Kentucky as the third or fourth most over-medicated state, and said that the actual numbers may be worse.
"I'm sick and tired of losing an entire generation to prescription drug abuse," he said.
The regions with the highest numbers of drug deaths are in the Appalachia and the Southwest, from coal-mining communities in West Virginia to Indian reservations in New Mexico.
"People don't see them as dangerous, people don't see them as addictive, and people don't see them as fatal," Kerlikowske said. "We've become an over-medicated society."
Florida Attorney General Pam Bondi said the epidemic has other consequences. She said at one hospital in Tampa, 20 percent of the babies born were born addicted to prescription drugs.
"Imagine the worst addict you see on TV going through withdrawals — that's how these babies come into this world," she said.
Florida was the epicenter of prescription drug "pill mills" until the Florida Legislature passed a tough prescription drug law last year, a law Bondi called "long overdue."
A statewide crackdown that began a year ago resulted in 2,000 arrests, and the seizure of nearly half a million pharmaceutical pills. But the enforcement efforts are pushing the illegal pain clinics northward into other states, such as Georgia, Tennessee, Kentucky and Ohio.
Forty states have begun Prescription Drug Monitoring Programs, which help prosecute those who are behind rogue pain clinics, but Conway and Bondi said states need to do a better job of sharing information.
"You can pass these laws and move on, but that doesn't work," Bondi said.
Joseph Rannazzisi, the deputy assistant administrator for the Drug Enforcement Administration's office of diversion control, said 99 percent of doctors comply with efforts to crack down on illegal prescription drugs, but it's that tiny 1 percent that accounts for most of the problem.
Conway said only 25 percent of physicians in Kentucky are registered with a state system that can show whether patients are "doctor shopping" to get prescription drugs illegally. Compliance is voluntary, and Conway conceded that many doctors regard it as time-consuming. Such registries also raise privacy concerns.
"We have a little bit of a battle with our medical community," he said.
Drug enforcement officials have tried to get people to give up prescription pills voluntarily, and the DEA has collected 500 tons of unwanted or expired medications through these efforts. Bondi said drop boxes recently set up at police stations collected five tons of prescription drugs.
"This is a war on drugs," Bondi said. "The drugs have changed."
Rep. Cliff Stearns, R-Fla., asked Rannazzisi: "Are we winning or losing?"
"We're moving ahead," Rannazzisi replied.
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