WASHINGTON — U.S. Rep. Hal Rogers' voice grows tight with frustration whenever he talks about the prescription drug epidemic that's gripped Appalachia for more than a decade.
"Crook doctors operating these pill mills" in Florida are running rampant and are fueling the flow of illegally obtained prescription drugs to states like Kentucky, Rogers told Attorney General Eric Holder during a recent hearing.
"My people are dying," said the chairman of the House Appropriations Committee.
"They're not your people," Holder responded. "They're my people; they're American citizens."
But for Kentucky lawmakers like Rogers, R-Somerset, who've long been on the front lines battling an epidemic of pain pill abuse that has swept Appalachia and is now seeping from its epicenter in Florida across the country, the battle feels personal.
While Rogers appreciates the administration's current efforts, he feels the problem was ignored for far too long on the federal level. More needs to be done, he says.
The White House "has got to act," Rogers said. "We've got more people dying of prescription drug overdoses than car accidents."
The Obama administration counters that it is the first to publicly call the prescription drug abuse problem an epidemic and says it has stepped up drug busts and directed millions in funding to state-operated prescription monitoring programs. The administration says it also has focused efforts on the Appalachia High Intensity Drug Trafficking Area, which includes 68 counties in Kentucky, Tennessee and West Virginia.
"We've been laser-focused on this issue since day one," said Rafael Lemaitre, a spokesman for the Office of National Drug Control Policy.
Following up on a recent tour of Appalachian areas that have been especially hard hit by the prescription drug abuse epidemic, White House drug czar Gil Kerlikowske called on Thursday for a multipronged approach to fighting the problem.
Kerlikowske spoke to members of the Congressional Caucus on Prescription Pill Abuse, formed last year by Rogers and Rep. Mary Bono Mack, R-Calif., and stressed the need for stronger law enforcement, education and prescription drug monitoring to help combat abuse.
"I commend director Kerlikowske for his commitment to tackling this seemingly insurmountable challenge head-on," Rogers said. "After spending four days in my state, I am confident he has a true appreciation for the odds we're facing in the commonwealth, particularly where the pill pipeline from Florida is concerned."
In the meantime, Rogers hopes legislation he's co-sponsoring with Rep. Vern Buchanan, R-Fla., calling for a tougher federal crackdown on so-called "pill mills" — pain clinics that dispense prescription drugs — will help stem the flow of drugs across state lines.
The measure includes provisions to support state-based prescription drug monitoring programs; to use the money from seized illicit operations for drug treatment; to strengthen prescription standards for certain addictive pain drugs; and to toughen prison terms and fines for pill mill operators.
The bill comes on the heels of Florida Gov. Rick Scott's calls to repeal a monitoring program modeled after Kentucky's and designed to stanch interstate prescription drug trafficking — a move some Florida and Kentucky lawmakers and White House officials say will stymie efforts to curb the problem.
Scott has cited concerns about costs and patient privacy rights and has since turned down a $1 million donation from pharmaceutical giant Purdue Pharma, the maker of OxyContin, meant to help pay for a prescription database to combat Florida's illegal trade in painkillers.
Scott's efforts to repeal Florida's monitoring program threatens years of work by Kentucky's congressional delegation to combat the problem by channeling federal money into prevention, treatment, law enforcement and prescription monitoring.
Despite some success, including several high-profile drug busts and the adoption of prescription drug monitoring programs in 43 states, the problem is now so entrenched that the cheap flights drug traffickers use to fly from Florida to Kentucky and other states to peddle "hillbilly heroin" are nicknamed the "OxyContin Express."
Although the problem is most acute in Appalachia, a Substance Abuse and Mental Health Services Administration national study found in 10 years a fourfold increase in treatment admissions for prescription pain pill abuse. 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 opioid dependence.
The continued prevalence of prescription drug abuse "just points out how critical a monitoring system is," said Rep. Ben Chandler, D-Versailles. "The sad thing is because other states won't do it we still have an enormous issue and people will die as a result."