The Obama administration on Tuesday unveiled a plan to fight prescription-drug abuse, warning that accidental overdoses now exceed combined deaths from crack in the 1980s and black-tar heroin in the 1970s.
The initiative to fight the nation's fastest-growing drug problem includes boosting awareness among patients and health care providers of the dangers of prescription-drug abuse, cracking down on pill mills and "doctor shopping" and requiring drug manufacturers to develop education programs for doctors and patients.
"The toll our nation's prescription-drug-abuse epidemic has taken in communities nationwide is devastating," said Gil Kerlikowske, the White House director of national drug-control policy. "The severity of the public health epidemic requires a sustained, national effort."
Accidental drug overdoses are now the leading cause of accidental death in Kentucky and 16 other states, ahead of car crashes, Kerlikowske said.
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The rate of overdose-related deaths among men in Kentucky more than doubled from 2000 to 2009 and tripled among women. The total number of overdose deaths rose from 403 in 2000 to 978 in 2009, according to statistics released by the state Cabinet for Health and Family Services.
In Florida — the source of much of the drugs — there are seven overdose deaths a day. In Broward County alone, more than one million pain pills are dispensed every month, according to the Broward Sheriff's Office.
Brent Turner, the commonwealth's attorney for Floyd County, said his community has been hit hard with confirmed overdose deaths, which have jumped from 15 in 2009 to 43 in 2010, in the county of about 39,500 people.
In addition to driving up overdose deaths, abuse of pills feeds crime in the mountainous county, makes it hard for businesses to find drug-free employees and results in children being taken away from parents addicted to painkillers, Turner said.
"We just have a whole generation of kids that are being raised by their grandparents," he said. Any effort by the federal government to help with the prescription-pill problem "is certainly welcome and positive."
The Obama administration's plan — which comes a week after Florida Gov. Rick Scott said he'd no longer object to a state program to monitor prescription drugs — calls on every state to develop a monitoring program similar to one Kentucky operates and encourages them to share the information with other states. Thirty-five states already have such monitoring programs in place, Kerlikowske said.
However, various states collect different information and provide access to the monitoring systems to different users. In some cases, access for police is limited.
"Until every state has a monitoring program and can share information, addicts and traffickers will travel to the states without such systems in order to get pills," said Frank Rapier, head of the Appalachia High Intensity Drug Trafficking Area, a three-state federal task force headquartered in London.
Thousands of people from Eastern Kentucky and Appalachia routinely go to Florida — which has no monitoring system in place — to get prescriptions at so-called "pill mills," then take them home to use or sell.
With authorities in Florida trying to crack down on unscrupulous clinics, Georgia, which also has no prescription-monitoring system, has become a growing source of pills coming into Kentucky, law enforcement officials say.
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 single day, he said. Drug Enforcement Administration Administrator Michele M. Leonhart said the agency will hold another "take-back" day on April 30.
The plan also calls for the drug-control policy office and the Drug Enforcement Administration to provide training to states with the greatest need.
Law enforcement agencies and the lawmakers who represent them have long complained that storefront clinics where pain medication often is dispensed without prescriptions, or "pill mills," contribute heavily to the prescription-drug epidemic.
In Florida, Attorney General Pam Bondi has pushed for increased penalties and tools for law enforcement to pursue unscrupulous pain-clinic operators. Gov. Rick Scott last month launched a statewide "strike force" to go after the problem.
Some in the pain-clinic industry saw the Obama administration's announcement as an attack.
"Until this country starts funding drug-treatment programs to the level required, we are just going to have full jails and a move to the next easily available and inexpensive drug, which now seems to be heroin," said Paul Sloan, president of the Florida Society of Pain Management Providers. "The worst part of all this is that instead of war on medication abuse, it has now become a war on pain patients."
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 level, employment level and region.
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 educational plan to help doctors and patients.
The FDA says the extended-release opioids — including OxyContin, Avinza, Dolophine, Duragesic and eight other brand names — are "extensively misprescribed, misused and abused, leading to overdoses, addiction and even deaths."
Kentucky's congressional delegation applauded the administration's announcement. Senate Minority Leader Mitch McConnell's staff said he "looks forward to reviewing this new strategy."
Republican Rep. Hal Rogers of Somerset, co-chairman of the Congressional Caucus on Prescription Drug Abuse, pointed to Operation UNITE as a model of how states can tackle the problem from every angle — education, treatment and law enforcement.