Combating the epidemic of prescription drug abuse is like playing Whac-a-Mole.
Crack down on one pill mill or pill pipeline and two others pop up, as law enforcement officials say is happening in Kentucky.
With such a resilient market, the only real solution is reducing demand. Overdoses now kill more Kentuckians than car crashes — that's how pervasive this plague has become.
Don't imagine it's just an Eastern Kentucky problem. As the Herald-Leader has recently reported, the entire state also is suffering from an epidemic of fly-by-night "pain clinics."
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Kentucky's efforts to reduce demand by treating drug addiction and preventing people from falling into the pit of drug abuse have never come close to meeting the need. The state Medicaid program does not cover drug treatment. Addicts usually go on a waiting list for a treatment program, which means the desire to quit may evaporate before a bed opens up.
It still won't be enough, but the legislature should have more money to invest in drug treatment in the next state budget as savings from this year's penal reforms begin to accrue.
It's still unclear how much will be saved from imprisoning fewer Kentuckians. The Department of Corrections is working on the calculations. But the law enacted earlier this year requires that a good bit of the savings go into drug treatment and drug courts.
Savings could be trimmed by an unexpected uptick in the prison population; there were 1,000 more prisoners this July than the previous July. But over time the savings from locking up fewer addicts will free up money to tackle the drug problem by reducing demand.
The public should be vigilant about making sure the money promised for drug treatment doesn't end up somewhere else in a strained state budget.
Meanwhile, the supply side also merits lawmakers' attention.
We understand that physicians prescribing painkillers have tough calls to make in a state where the disability rate from occupations such as mining, farming and manufacturing is high, and where poverty takes a deep psychic toll.
But when cars from other states and all over Kentucky are streaming into a newly opened storefront clinic and patients are lining up out the door, it's not that hard to figure out what's going on.
While the effects of these questionable pain clinics may not be as chemically toxic as the manufacture of methamphetamine, they too have a poisonous effect on their neighborhoods and communities.
The legislature can take a few simple steps to increase the licensing requirement for pain clinics without burdening legitimate medical practices. For example, requiring criminal background checks of those seeking to open pain clinics and barring convicted felons seem reasonable, as does requiring that a physician have an ownership interest in a pain clinic.
The medical profession should also step up and do more to educate physicians and, when necessary, weed out those who are trading on addiction.