Beshear pledges to run 'pill mill' doctors out of Kentucky

UK summit addresses prescription drug problem

bestep@herald-leader.comFebruary 1, 2012 

Curbing Kentucky's increasing problem with prescription-drug abuse will be one of the top priorities of the current legislative session, Gov. Steve Beshear said Wednesday.

Beshear said a bill will be introduced soon that will call for tighter controls on pain clinics and wider use of the state's prescription-monitoring system, among other things.

One goal will be to crack down on so-called "pill mills" — offices where doctors give prescriptions for powerful painkillers and other drugs to addicts, usually with little or no real physical examination.

"We're gonna run 'em out of the state," Beshear said of doctors who improperly overprescribe pills.

Beshear was one of more than two dozen speakers at a daylong summit Wednesday at the University of Kentucky on the state's prescription-drug abuse problem.

The state's two U.S. attorneys, Kerry Harvey and David Hale, arranged the conference in partnership with the medical, pharmacy and dentistry schools at UK.

The goal was to increase awareness of Kentucky's crippling level of prescription-drug abuse and increase collaboration among police, health care providers and others in tackling the problem.

More than 300 people attended the summit.

The law-enforcement attack on drugs has gotten a lot of attention, but speakers said it would take a collaborative effort by police, health care providers, educators, policymakers, business, community volunteers and others to drive down prescription abuse.

"If we leave this to law enforcement alone, we're destined to fail," Harvey said.

It's not an overstatement to describe prescription-drug abuse in Kentucky as an epidemic, people at the summit said.

Speakers offered these illustrations of the problem:

■ Kentucky's level of prescription abuse is among the highest in the country — 30 percent higher than the national average.

■ Use of the painkiller hydrocodone went up 477 percent from 2004 to 2009.

■ More babies are being born addicted, pushing up health costs.

■ Drugs play a role in 80 percent or more of crime in some places.

■ An estimated 82 people die of drug overdoses in Kentucky each month, though police said the number actually is higher because autopsies that would spot drug involvement are not performed in many deaths.

"This is a corrosive evil, and we have to stop it," Beshear said.

Brent Turner, the commonwealth's attorney for Floyd County, said prescription-drug abuse has increased substantially since he took office in 2000 despite efforts to put traffickers in jail.

He painted a bleak picture, with overdose deaths "skyrocketing"; a spike in armed robberies connected to drugs; employers unable to fill jobs because people can't pass drug tests; children being raised by grandparents because their parents are in jail for drug offenses; addicts selling food stamps to get money for drugs, leaving their children to go hungry; and a growing underground market for clean urine so addicts can pass drug tests ordered by employers and courts.

"We're drowning in a sea of pills," Turner said, adding that drug abuse would destroy the region if policymakers and others don't do more.

Several speakers said part of the answer is more education for prescribers, for communities and especially for young people, many of whom don't recognize the dangers of prescription drugs.

Chronic drug abusers often get their pills at pill mills, but the medicine cabinet is a source for many young people, speakers said.

"This is a problem that is starting in our homes," said Attorney General Jack Conway.

More than 70 percent of young people get the pills they abuse from friends or relatives, said Thomas Gorman, who oversees the U.S. Drug Enforcement Administration in Kentucky.

People need to lock up their prescription drugs and dispose of them properly when they're no longer needed, speakers said.

Conway and others said the state also needed tougher rules.

Beshear, Conway and House Speaker Greg Stumbo, D-Prestonsburg, plan to push legislation that probably will include provisions requiring more doctors to use the state's prescription-monitoring system, speed up reviews of doctors suspected of overprescribing and new controls on pain clinics.

Beshear, a Democrat, has often clashed with the Republican president of the state Senate, David Williams, but he said Wednesday that he thinks Williams will support the effort to curb prescription-drug abuse.

Police said Kentucky has a problem with non-doctors owning such clinics and operating them to generate cash, not treat patients.

State police Maj. Anthony Terry said there are about 70 pain clinics in Kentucky, and more than 30 are not owned by doctors.

"They keep us very busy," he said.

Wilfredo Ferrer, the U.S. attorney for Southern Florida, said at the summit that tougher enforcement, new laws and a new prescription monitoring system are helping reduce the flow of pills from his area to Kentucky and other states.

In 2010, 90 of the top 100 physician buyers of oxycodone were in Florida, but in 2011 that number dropped to 13 and the amount of the drug Florida doctors bought dropped 97 percent, Ferrer said.

He said Florida authorities see fewer Kentuckians coming for pills, but there are indications they've switched to other places to get drugs, including Georgia, which does not have a prescription-monitoring system in place.

Several speakers at the conference also said there was a need for more substance-abuse treatment.

If people can't get treatment when they want it, they will keep abusing drugs to stave off painful withdrawal, doctors said.

"We need more substance-abuse treatment," said Dr. Michelle Lofwall, an addiction psychiatrist at UK. "We need a lot more."

Beshear noted his proposed budget includes funding through Medicaid for substance-abuse treatment for an additional 5,800 people over two years. He acknowledged that pales when compared to the need.

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